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Published on: May 11, 2011
Rapid arteriotomy or venotomy site closure using a pre-placed purse-string suture technique in dogs
K V Pierce1, B A Scansen2, Z English3
1Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA; Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA.
Introduction/Objectives:
Ligation of a catheterized vessel after image-guided intervention is common in veterinary medicine, which may affect vascular supply or limit future access. This prospective case series investigated the utility of a preplaced purse-string suture technique for rapid closure of vascular catheterization sites in dogs.
Animals, Materials And Methods:
Vascular cut down was performed, and a purse-string suture was preplaced around the intended puncture site using 6-0 monofilament, non-absorbable polypropylene suture in 45 vessels from 40 dogs undergoing femoral arterial (n = 35), femoral venous (n = 4), or carotid arterial (n = 6) catheterization. Within the loose preplaced suture pattern, vessel puncture was performed with an over-the-needle catheter, and an introducer sheath was placed. When the intended procedure was finished, the introducer sheath was removed, while the preplaced suture was tightened and tied to achieve hemostasis at the access site.
Results:
Complete hemostasis was achieved immediately in 16 vessels at time of purse-string closure; partial hemostasis requiring additional suture placement was achieved in an additional 25 vessels. Ligation was necessary in five vessels. Vessel repair with this technique was successful in 40 of 45 (88.9%) vessels.
Study Limitations:
Several patient and procedural variables investigated were under-represented due to the convenience sample obtained. A suspected learning curve also adds complexity to assessing factors that may impact success.
Conclusions:
Suture-mediated, preplaced vascular closure is a low-cost and effective option for vascular closure that may avoid vessel ligation after vascular access in dogs.
