Alternative sites for continuous arterial monitoring

During a 13-month period, we studied 148 patients who had percutaneous arterial cannulation for continuous intraoperative, postoperative, and intensive care monitoring. In all patients, alternative arteries were cannulated, which included the brachial (43%), axillary (19%), femoral (28%), dorsalis pedis (8%), and superficial temporal artery (1%). No patient sustained any functionally significant or serious complication requiring surgical intervention. Eighteen patients (12%) had minor, clinically insignificant complications. We conclude that in the absence of an available radial artery, there are at least five other reliable arterial sites that may be cannulated and safely used when direct arterial monitoring is required.