The value of the oblique groin incision for femoral artery access during endovascular procedures

Groin incisions for access to femoral vessels are typically made in a verti cal fashion extending across the groin crease. Significant morbidity can be associated with these incisions, including lymphoceles, lymph fistulae and infections, as documented in the infrainguinal revascularization literatur e. We have adopted an oblique groin incision for femoral artery access duri ng endovascular graft reconstruction of the aorta because of the potential for reduced wound morbidity. in this study we report our experience with th is technique and compare it with the existing literature to determine its u sefulness. From June 1998 to May 1999, 98 consecutive patients received end ovascular exclusion of aortic aneurysms at The Mount Sinai Medical Center, New York. Patients were treated with aortoaortic (24), aortouniiliac with f emorofemoral crossover bypass (41), or bifurcated endografts (33) and were prospectively studied for wound complications. Aortoaortic procedures requi red one inguinal incision whereas aortouniiliac with femorofemoral crossove r bypass and bifurcated procedures employed bilateral inguinal wounds. Woun d complications were defined as cellulitis, subcutaneous purulence, femorof emoral graft infection, lymphocele, or lymphocutaneous fistulae. The obliqu e groin incision allows adequate exposure to the femoral arteries and is as sociated with low wound morbidity. We suggest that this approach may be the preferred technique for access to femoral arteries during endovascular pro cedures, and should be considered for infrainguinal arterial reconstruction s. DOI: 10.1007/s100169910042.