In postprocedure care after renal angiography via a femoral puncture, which action is appropriate?

• A. Check the pedal pulses frequently
• B. Keep the knee on the affected side bent for 6 hours
• C. Apply pressure to the puncture site for 30 minutes
• D. Remove the dressing on the puncture site after vital signs stabilize

Answer: (A)

Monitoring distal perfusion is essential after femoral arterial access used for renal angiography. Checking the pedal pulses frequently gives a real-time read on blood flow to the leg and helps detect early signs of arterial occlusion, hemorrhage, or evolving hematoma. Detecting this promptly is crucial to prevent limb-threatening ischemia and guide timely intervention.

Keeping the knee bent for several hours disrupts normal limb position and can interfere with blood flow and healing at the access site. Applying a fixed 30-minute pressure period doesn’t account for the individual healing response and may either fail to achieve proper hemostasis or risk causing ischemia if pressure is excessive. Removing the puncture-site dressing once vital signs stabilize can hide ongoing bleeding or hematoma formation and compromises monitoring of the access site.