{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T16:59:17Z","timestamp":1793465957511,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ultrasound\u2010guided puncture of the common femoral artery (CFA) is assumed to be more precise than conventional techniques without ultrasound. However, previous comparative studies have shown partly contradictory results with regard to success of ultrasound\u2010guided puncture so that this method is not yet standard in transfemoral cardiac catheterization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The PARFEM trial was performed to investigate whether an ultrasound\u2010assisted in\u2010plane technique using a needle guide could improve the precision of CFA puncture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted in 286 patients undergoing transfemoral cardiac catheterization. Patients were randomized 1:1, and femoral artery puncture was performed either using an ultrasound\u2010guided in\u2010plane technique with fluoroscopic marking of the center of the femoral head or a conventional approach. The primary endpoint was successful puncture of the CFA with the first attempt. In addition, the influence of the examiners' level of experience on puncture results was investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Primary successful puncture of the CFA was achieved more frequently in the ultrasound group than in the control group: 79.6% versus 55.6%, odds ratio 3.25 [95% CI: 1.92\u22125.23],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001. This favorable effect of ultrasound guidance was independent of the examiners' level of experience. The success rate of ultrasound\u2010guided sheath placement within the CFA was 97.2%, compared to 77.8% in the control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PARFEM trial demonstrated that in\u2010plane ultrasound guidance can improve the precision of femoral puncture and reduce the occurrence of inadequate sheath placements. The results support the incorporation of this technique into standard practice for guiding transfemoral puncture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      Identifier: NCT06065943.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31733","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:09:10Z","timestamp":1753870150000},"page":"2252-2262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Can Ultrasound\u2010Guided in\u2010Plane Puncture Technique Enhance the Precision of Femoral Artery Access? The Randomized PARFEM Trial"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1773-6503","authenticated-orcid":false,"given":"Wolfram","family":"Voelker","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Lachmann","sequence":"additional","affiliation":[{"name":"Caritas\u2010Krankenhaus Bad Mergentheim Bad Mergentheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5598-5359","authenticated-orcid":false,"given":"Guelmisal","family":"Gueder","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Bayik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8376-7711","authenticated-orcid":false,"given":"Margarete","family":"Heinrichs","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4092-1432","authenticated-orcid":false,"given":"Ralph","family":"Kickuth","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4652-7313","authenticated-orcid":false,"given":"Wolfgang R.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjoern","family":"Lengenfelder","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-4068","authenticated-orcid":false,"given":"Peter","family":"Nordbeck","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0301-6185","authenticated-orcid":false,"given":"Stefan","family":"Frantz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Cardiology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1771-7249","authenticated-orcid":false,"given":"Stefan","family":"St\u00f6rk","sequence":"additional","affiliation":[{"name":"Department Clinical Research &amp; 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