Ultrasound-guided perfusion index adjustment for hemostatic outcomes after femoral artery access in vascular interventions: a randomized controlled trial

Front Med (Lausanne). 2026 Feb 24:13:1735224. doi: 10.3389/fmed.2026.1735224. eCollection 2026.

Abstract

Objective: To evaluate the effect of adjusting the perfusion index (PI) under ultrasound guidance on hemostasis at the femoral artery puncture site in patients undergoing vascular interventional therapy.

Methods: A total of 98 patients undergoing vascular interventions at Ganzhou People's Hospital between July 2025 and September 2025 were randomized into two groups. The Trial group (n = 50) received ultrasound-guided initial compression to identify the optimal puncture site and establish a target PI from the great toe; a pressure bandage was subsequently applied to maintain the PI at or below this target. The Control group (n = 48) underwent conventional compression based on clinical experience and assessment of the dorsalis pedis artery pulse. The outcomes measured included hemostasis success upon bandage removal, Visual Analog Scale (VAS) pain scores assessed by a senior clinician, and PI values.

Results: The effectiveness of compression hemostasis at the puncture site was significantly improved in the Group T after compression hemostasis with a pressure bandage compared to the Group C (16% VS 41.7%; difference, 25.7%; RR, 95% CI, 0.384, 0.187 to 0.787, p = 0.005).

Conclusion: The adjustment of the PI value under ultrasound guidance significantly outperforms hemostasis when compared to empirical blind assessments following vascular interventional therapy.

Clinical trial registration: ChiCTR.org.cn, identifier (ChiCTR2500105617).

Keywords: femoral artery; hemostasis; interventions; perfusion index; ultrasound; vascular.