With the assistance of ultrasound guidance successful arterial and venous access from the arm should be the norm and crossovers extremely rare as the discomfort with arm access is often minimal sedation can potentially be eliminated in selected cases enabling easy access to the catheterization lab and expedited discharge. Femoral vascular access site complications in the cardiac catheterization laboratory diagnosis and management eviewr vascular access site complications remain a major cause of morbidity and mortality with cardiac catheterization and percutaneous intervention using the femoral approach complications may be divided into major and minor. Ultrasound guidance is widely used for central venous access in numerous hospital settings such as emergency departments ed intensive care units icu and radiology but is seldom used in the cardiac catheterization lab cath lab despite growing evidence of its potential benefit and utility. Historically arterial access in the cardiac catheterization laboratory has been obtained using anatomic landmarks along with pulsation and or fluoroscopic guidance for femoral access despite wide use outside the cardiac catheterization laboratory for vascular access with guideline recommendations endorsing its use 7 the use of ultrasound . Arterial and venous access in the cardiac catheterization lab is an invaluable resource for a wide range of clinical personnel from attending physicians and trainees to nursing staff and vascular technicians
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