Pre-procedural femoral vessel ultrasound in dogs with patent ductus arteriosus: diameter, image quality and relationship with arterial catheterization

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IntroductionObjectives: Patent ductus arteriosus (PDA) in dogs is often treated via minimally invasive transvascular occlusion using femoral artery access. This study compared ultrasound-derived diameter and image quality of the right femoral artery (RFA) and vein (RFV) in dogs with PDA using a linear ultrasound probe (L-P) and phased-array transthoracic echocardiography probe (TTE-P). The case outcome was assessed. Animals, materials & methodsForty-five client-owned dogs with PDA were prospectively enrolled. Ultrasound-measured RFA and RFV diameters were obtained on images acquired with both probes pre-operatively and compared using Bland–Altman plots. The image quality of RFA and RFV was scored on L-P and TTE-P images. ResultsComparison of RFA and RFV diameter from L-P versus TTE-P images revealed: [Mean difference (limits of agreement): RFA = 0.009 mm (−0.78–0.79 mm), RFV = 0.523 mm (−1.75–2.79 mm)]. Image quality scores were significantly higher for L-P than TTE-P (P < 0.0001). In six small dogs, measurable images were unattainable with TTE-P. Dogs of similar body weight had variable RFA diameters. Twenty-seven dogs had RFA catheterization. In 21/27 dogs, RFA diameter exceeded the external diameter of the introducer used for catheterization, and in 6/27, it was smaller. ConclusionsPre-procedural ultrasound of the RFA in dogs with PDA is useful given variable RFA diameter relative to body weight. Despite poorer image quality, RFA diameters from TTE-P images were very similar to L-P images on average, suggesting TTE-Ps are suitable for pre-procedural planning in most dogs. Vasospasm, hypotension or differences in the location of ultrasound measurement versus catheterization might produce variation in pre-procedural versus intraoperative RFA size.