Radial arterial lines have a higher failure rate than femoral

Matthew Greer, Scott Carney, Rick A. McPheeters, Phillip Aguiniga, Stephanie Rubio, Jason Lee

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Arterial lines are important for monitoring critically ill patients. They are placed most commonly in either femoral or radial sites, though there is little evidence to guide site preference. Methods: This is an ambispective, observational, cohort study to determine variance in failure rates between femoral and radial arterial lines. This study took place from 2012 to 2016 and included all arterial lines placed in adult patients at a single institution. Causes of line failure were defined as inaccuracy, blockage, site issue, or accidental removal. The primary outcome was line failure by location. Secondary outcomes included time to failure and cause of failure. Results: We evaluated 272 arterial lines over both arms of the study. Fifty-eight lines eventually failed (21.32%). Femoral lines failed less often in both retrospective (5.36% vs 30.71%) and prospective (5.41% vs. 25.64%) arms. The absolute risk reduction of line failure in the femoral site was 20.2% (95% confidence interval [3.7-36.2%]). Failures occurred sooner in radial sites compared to femoral. Infection was not a significant cause of removal in our femoral cohort. Conclusion: Femoral arterial lines fail much less often then radial arterial lines. If placed preferentially in the femoral artery, one line failure would be prevented for every fourth line.

Original languageEnglish (US)
Pages (from-to)364-371
Number of pages8
JournalWestern Journal of Emergency Medicine
Issue number2
StatePublished - Mar 1 2018
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine


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