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Traditionally, common femoral artery (CFA) access procedures were, and still commonly are, performed via direct palpation of the CFA. This method, using estimation, has been thought to contribute to vascular complications, with the trend now favoring ultrasound (US) guided CFA access. While there is added time and cost associated with its use, a study conducted in 2013 by Gedikoglu et al. demonstrated that US guidance improved the rate of vascular complications associated with vascular access when compared to the traditional palpation-guided procedure. This is a retrospective study analyzing completed CFA-access procedures performed by interventional cardiologists at a single center that aims to confirm the results of the Gedikoglu et al. study. We proposed that using US-guided techniques for CFA access would decrease post-procedural complications, thereby improving patient outcomes. Data were collected on patients with CFA access using either palpation (n= 453) or US (n= 122) guidance. Patient outcomes were measured and defined via the occurrence of access site complications including: pseudoaneurysms, AV fistulas, hematomas (defined as > 1 cm), or retroperitoneal bleeding. Statistical analysis was conducted using a logistic regression model to understand the associations between these complications and several independent variables including, but not limited to: hypertension, diabetes, hyperlipidemia, previous MI and diagnostic vs. interventional procedures. There was insufficient evidence to claim significant differences in the proportions of pseudoaneurysm, AV fistula, and retroperitoneal bleeding for both cohorts; therefore, the analysis focused on hematoma occurrence. After adjusting for gender, BMI, and periprocedural antithrombotic therapy use, the odds of having a hematoma for patients with palpation were found to be 3.4 times that of patients with US (p =0.047). This reflects a 240% increase in risk of hematoma with palpation guidance alone. Therefore, our results confirm that there is a significant improvement of patient outcomes in relation to the development of hematoma using US-guided CFA access versus palpation. Thus, as current trends have been toward implementing US guidance in CFA access procedures, larger studies may need to be done to determine whether other complication rates are also improved to prevent redundant health-care costs and hospital length of stay associated with vascular access complications.