CRANIAL TIBIAL ARTERY CATHETER FOR MONITORING PRESSURES AND SAMPLING

Abstract

A technique for placement of a long‐term arterial catheter that the author developed was used in 20 canine patients. The catheter was used for pressure monitoring and arterial blood sampling. The technique involved the following steps post‐sedation and placement of a local anesthetic: Clipping and prepping of the medial aspect of the distal tibia and proximal metatarsal region; Incision over the medial tibial malleolus just caudal to the cranial tibial muscle‐tendon; Blunt dissection of the space just caudal to the cranial tibialis tendon; Isolation of the cranial tibial artery and loop placement proximally and distally; Placement of a 3 Fr. polyurethane 4–8 cm catheter using a Seldinger wire technique; Placement of a suture in the periosteium of the distal tibia and anchoring of the catheter with this suture; Closure of the skin incision with sutures or staples; Bandage application to hold the catheter in place. The entire surgical procedure was done using sterile technique. The catheter was able to be kept in place and working for up to 9 days (averaged 4 days). This compared favorably retrospectively over dorsalis pedis catheters that lasted only a maximum of 4 days. (average 1.5 days). Because of the size of the catheter (3 Fr.) it provided improved waveforms over that observed with the dorsalis pedis catheter (22 g) and its occlusion rate was very low (2 in 20). The cranial tibial artery catheter was found to be particularly effective because the catheter was able to be inserted several cm up the artery and the catheter was able to be anchored well. No major complications were observed with this technique. Because of its effectiveness it is recommended to be used routinely over femoral artery and dorsal pedis artery catheters.