Percutaneous cannulation of the dorsalis pedis artery. A prospective study

Strain-gauge plethysmography was used to determine the systolic arterial pressure in the great toe of 38 patients (aged 23-70 yr) undergoing lung surgery. In eight patients (21%) manual compression of the dorsalis pedis artery reduced the arterial pressure in the great toe to less than 40 mm Hg, and cannulation of the artery was not attempted. In 24 of 30 patients with adequate collateral arterial supply, a Teflon cannula (Venflon 1.20) was inserted percutaneously to the dorsalis pedis artery. Median cannulation time was 160 min. Six patients (25%, 95% confidence limits 10-47%) developed thrombosis of the artery and, in one, unsuccessful cannulation caused thrombosis. In two patients, recanalization of the artery occurred between the 2nd and the 8th day after operation. In four patients, examination 3-5 months after cannulation revealed a persisting decrease in the function of the dorsalis pedis artery. This suggests that the dorsalis pedis artery should not normally be selected for cannulation.