Fig. 2.

Common femoral artery cannulation. a Common femoral artery cannulation using the open Seldinger technique. The common femoral artery is exposed by giving a vertical or transversely oblique incision at mid-inguinal point, just below inguinal crease. b The incision is deepened up to the femoral sheath. The femoral sheath is opened in a limited manner to expose about 3 cm of common femoral artery (CF, common femoral artery; PF, profunda femoral artery; SF, superficial femoral artery). Excessive dissection of the artery should be avoided, and it should not be bared off its adventitia. c A superficial U-shaped purse-string suture is placed in the adventitia. One should avoid a circular purse-string suture. d Puncture is made through the U-suture. A guidewire is passed. e The cannula, mounted on the dilator, is threaded over the guidewire. f At the end, the cannula is removed and arteriotomy is temporarily controlled with the purse-string suture. Proximal and distal clamps are applied, and the original purse-string suture is removed. The arteriotomy is closed transversely. We do not tie the original purse-string suture as it may pucker the artery and compromise the lumen. g When the artery is small, an 8-mm vascular graft is sutured to the common femoral artery in an end-to-side fashion. The graft is connected to the arterial line. h Prevention of lower limb ischemia. An 8-mm sheath is inserted in the superficial femoral artery and directed distally. The sheath is connected to proximal hub of the main arterial cannula using a luer-lock connector