Percutaneous-based procedures continue to increase as endovascular techniques improve and provide a less morbid approach than the open vascular procedures. The most common complications associated with either cardiac interventions or peripheral interventions involve the access point of the procedure. The retrograde femoral access has and is currently the most frequently used arterial access. Vascular surgeons have been responsible for management of complications following femoral-based procedures and now are a significant contributor to catheter-based diagnostic and interventional procedures. This review provides in-depth review of the literature on specific complications encountered during percutaneous femoral artery puncture. This review includes access complications related to the method of obtaining access (ie, best pulse fluoroscopic guided), direction of access either retrograde or antegrade, risk factors and incidence of complications based on best literature sources, and management strategies for specific complications.
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