J Vet Sci.  2015 Dec;16(4):517-523. 10.4142/jvs.2015.16.4.517.

Chitosan hemostatic dressing for control of hemorrhage from femoral arterial puncture site in dogs

• Szatmari V

• KMID: 2133635
• DOI: http://doi.org/10.4142/jvs.2015.16.4.517

Abstract

Removal of an introducer-sheath from a femoral artery after completing transarterial embolization of a patent ductus arteriosus can cause life-threatening hemorrhage in dogs. In the present study, the effectiveness of chitosan acetate dressing in 10 experimental dogs was tested. Under general anesthesia, an introducer-sheath was placed into the femoral artery with percutaneous puncture using Seldinger's technique. The outer diameter of the introducer-sheaths varied from 3.0 to 4.0 mm with an introducer/artery ratio of 80 to 123%. The artery's diameter was measured using ultrasonography. Following removal of the introducer-sheath, a chitosan acetate dressing was applied to the wound and held in place with manual compression for 10 min. Successful hemostasis was reached on 12 arteries. However, on two arteries, hemorrhage was uncontrollable and led to a hypovolemic shock during 10 min of manual compression. Possible causes of the negative outcome in two dogs were their old age and an introducer-sheath with a too large diameter. The chitosan acetate dressing was easy to use and the artery remained patent. Dogs could walk directly after recovery from anesthesia and their femoral arteries were saved. In conclusion, the outer diameter of the introducer-sheath should not exceed 3 mm or the inner diameter of the artery.

Keyword

cardiac catheterization; patent ductus arteriosus

MeSH Terms

Anesthesia
Anesthesia, General
Animals
Arteries
Bandages*
Cardiac Catheterization
Chitosan*
Dogs*
Ductus Arteriosus, Patent
Femoral Artery
Hemorrhage*
Hemostasis
Punctures*
Shock
Ultrasonography
Wounds and Injuries
Chitosan

Figure

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  Fig. 1 Measurement of the internal diameter of the femoral artery on a cross sectional 2-dimensional ultrasound image.

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  Fig. 2 Removal of a 10-French introducer-sheath (with 4 mm outer diameter) from the femoral artery of an anesthetized Boerboel dog. The operator is compressing the artery proximally and distally to the puncture site with his fingers to prevent hemorrhage.

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  Fig. 3 The femoral arterial puncture site in an anesthetized beagle dog after removing the patch that was placed 30 min earlier, i.e., 30 min after removal of the introducer-sheath from the arterial lumen.

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  Fig. 4 The puncture site of the right femoral artery is covered with a HemCon patch. The introducer-sheath was removed 2 h before making this photograph.

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  Fig. 5 The femoral artery of a Boerboel dog 6 days after removal of the introducer-sheath. (A) 2-dimensional ultrasonography shows a small local aneurysm at the site of the puncture. (B) Color Doppler ultrasonography shows a patent lumen (the same longitudinal image as on panel A). (C) The dissected femoral artery (stored in formalin). Granulation tissue can be seen around the puncture site. (D) Photomicrogram of the femoral artery around the puncture site (arrow); longitudinal section. Lawson stain, scale bar = 500 µm.

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