Relationship of the Inguinal Ligament to Pelvic Radiographic Landmarks: Anatomic Correlation and Its Role in Femoral Arteriography

Because of the known risks of suprainguinal catheterization, an anatomic study of the inguinal ligament was performed in 10 cadavers. The position of the inguinal ligament as estimated by means of palpation and use of anatomic landmarks was compared with the actual ligament position as determined by means of groin dissection. Infrainguinal contrast material injections were also performed to assess competence of the inguinal ligament against spread of hematomas. The radiographically determined position was an average of 15.2 mm superior to the actual ligament position (range, 3 mm below to 24 mm above). The palpated position of the ligament was an average of 7.8 mm superior to its actual position (range, 7 mm below to 23 mm above). Contrast material injections demonstrated the inability of the inguinal ligament to contain blood or fluid, with formation of retroperitoneal hematomas. Puncture of the femoral vessels should be positioned in the midportion of the femoral head, as determined with fluoroscopy for maximum safety during catheterizations.