Iatrogenic femoral arteriovenous fistula.

Twelve iatrogenic femoral arteriovenous fistulas are reported, 11 of which arose from the superficial or deep femoral arteries. All but two occurred in association with cardiac angiographic procedures. It appears that the femoral crease was used as a landmark to establish the cutaneous entry point for vascular puncture and resulted in an excessively distal puncture site. The femoral crease is an unreliable landmark in many patients. This complication may be minimized by using physical examination to identify the level of the inguinal ligament or fluoroscopy to localize the distal half of the femoral head.