Diameter and depth of femoral vessels by duplex ultrasound

J Vasc Access. 2023 Dec 12:11297298231200036. doi: 10.1177/11297298231200036. Online ahead of print.

Abstract

Background: The anatomy of the femoral artery and vein plays an integral role in vascular access. Both technical feasibility and complication rates are associated with femoral vessel diameter and depth. The goal of this study is to establish normative values for common femoral artery (CFA) and vein (CFV) depth and diameter using a large, diverse patient population.

Methods: A retrospective review of all patients undergoing lower extremity venous duplex imaging over a 1 year period were reviewed. Patients with inadequate imaging or with evidence of deep vein thrombosis were excluded. The index image of all studies was a non-compressed view of the common femoral vein at the saphenous-femoral junction. All measurements were taken from this still. Vessel diameters were measured from intima to intima. Depth was measured from skin to intima. BMI and BSA were calculated using standard formulas. Chi square was used for univariate analysis. Linear regression was used to establish correlation.

Results: Over the 1 year period, 983 patients met criteria for inclusion. The majority were male (53%) with a mean age of 55. The patients were 47% white and 44% black. The majority had hypertension (53%). The mean BMI and BSA were 29 and 2, respectively. Mean CFA depth was 1.7 cm, while mean CFV depth was 1.8 cm. The mean CFA and CFV diameters were 0.9 and 1.1 cm, respectively. Amongst height, weight, BMI, and BSA, weight correlated best with CFA (R = 0.548) and CFV (R = 0.552) depth, while BSA correlated best for diameter for both CFA (R = 0.390) and CFV (R = 0.440).

Conclusions: This study establishes mean diameters and depths for the common femoral artery and vein using a large, diverse patient group. BSA was most closely associated with vessel diameter, while weight was correlated with depth. This study provides normative diameter and depth values for the common femoral vasculature, which may assist in vascular access planning for providers.

Keywords: Femoral anatomy; duplex ultrasound; vascular access.