Redefining landmarks to improve #safefemoral outcomes.

Retroperitoneal hemorrhage (RPH) and other femoral artery access site complications are associated with "high" arterial punctures. Using the nadir of inferior epigastric artery (IEA) as the landmark for identifying the inguinal ligament and high punctures can reduce access site complications. Traditional teaching of aiming for the middle of the femoral head while obtaining femoral access can result in higher than desired puncture site more frequently than aiming for the lower quarter. Enhanced understanding of anatomical landmarks, use of imaging guidance and strict adherence to safe access practices can help improve outcomes.