Retrograde cannulation is performed at which location?

• A. 2 cm below inguinal ligament, at least 1 cm above CFA bifurcation
• B. 2 cm above inguinal ligament
• C. At CFA bifurcation
• D. 2 cm below CFA bifurcation

Answer: (A)

The important concept is selecting the right site in the common femoral artery for retrograde arterial access. You want to puncture in the common femoral artery just below the inguinal ligament, staying well above its bifurcation into the superficial femoral and profunda femoris. Being about 2 cm below the inguinal ligament places you in the CFA, and being at least 1 cm above the bifurcation keeps you away from branching vessels. This location provides a large, easily cannulated vessel that is compressible for hemostasis and reduces risks from puncturing a branch or an iliac segment. Puncturing too high (above the inguinal ligament) enters the external iliac artery, while puncturing too close to or below the bifurcation risks entering a branch vessel or the superficial femoral/profunda branches, making cannulation less reliable and increasing complications.