Pediatric Radiology

, Volume 45, Issue 1, pp 86–93 | Cite as

Transient flow response after femoral artery catheterization for diagnostic neuroangiography in infants and children: Doppler US assessment of the ipsilateral femoral artery

  • Seong Ho Kim
  • Young Hun ChoiEmail author
  • Jung-Eun Cheon
  • Su-Mi Shin
  • Hyun-Hae Cho
  • So Mi Lee
  • Sun Kyoung You
  • Woo Sun Kim
  • In-One Kim
Original Article



Hemodynamic changes in the distal arteries during transfemoral catheterization in children have not been documented.


To evaluate arterial flow changes of the lower extremities ipsilateral to the puncture site using Doppler US during transfemoral cerebral angiography in children.

Materials and methods

Twenty-seven children who underwent transfemoral cerebral angiography at our institution between April 2013 and August 2013 compose our study population. Doppler US was performed to evaluate diameters and peak systolic velocities of the common femoral artery and superficial femoral artery before and after femoral sheath insertion. Children were classified into three groups based on the spectral waveform changes of the superficial femoral artery after femoral sheath insertion. Thereafter, one-way ANOVA followed by the Bonferroni post-hoc comparisons test were performed to compare values among the groups.


Mean common femoral artery and superficial femoral artery baseline diameters were 4.10 mm and 3.32 mm, and mean baseline peak systolic velocities were 218.26 and 166.51 cm/s, respectively. Fourteen of 27 children showed persistent triphasic flow in the superficial femoral artery (group 1); 7 children showed altered flow of biphasic (n = 3) or monophasic (n = 4) waveforms (group 2); and 6 children showed pulsus tardus et parvus pattern (group 3) after femoral sheath insertion. Mean baseline diameter of the common femoral artery and mean subtracted value between common femoral artery and femoral sheath size were significantly smaller in group 3 than the other groups. Size discrepancy between common femoral artery and femoral sheath was <1 mm in all cases of group 3. Superficial femoral artery diameter and peak systolic velocity significantly decreased after femoral sheath insertion in group 3 compared to groups 1 and 2. A significant skin temperature drop after sheath insertion in the ipsilateral lower extremity was noted in group 3 (−1.83°C), compared to groups 1 and 2 (+0.42 and −0.86°C, respectively).


Changes in the spectral waveforms of superficial femoral arteries frequently occur in children during transfemoral cerebral angiography (13/27, 48%). Significant arterial flow disturbance was noted on Doppler US in children with a common femoral artery <1 mm larger than the femoral sheath diameter.


Doppler Ultrasonography Lower extremity Children Infants Femoral artery Transfemoral catheterization 


Conflicts of interest


Supplementary material

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ESM 1 (JPEG 2114 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Seong Ho Kim
    • 1
  • Young Hun Choi
    • 1
    • 4
    Email author
  • Jung-Eun Cheon
    • 1
  • Su-Mi Shin
    • 2
  • Hyun-Hae Cho
    • 1
  • So Mi Lee
    • 1
  • Sun Kyoung You
    • 3
  • Woo Sun Kim
    • 1
  • In-One Kim
    • 1
  1. 1.Department of RadiologySeoul National University College of Medicine, Seoul National University HospitalSeoulSouth Korea
  2. 2.Department of RadiologySMG-SNU Boramae Medical CenterSeoulSouth Korea
  3. 3.Department of RadiologyChungnam National University HospitalDaejeonSouth Korea
  4. 4.Department of RadiologySeoul National University HospitalJongno-guSouth Korea

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