Chitosan hemostatic dressing in controlling hemorrhage from femoral arterial puncture site in dogs

Removal of an introducer-sheath from a femoral artery after completing a transarterial embolization of a patent ductus arteriosus can cause life-threatening hemorrhage in dogs. The present study tested the effectiveness of chitosan acetate dressing in 10 experimental dogs. 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 3.0-4.0 mm with an introducer/artery ratio of 80-123%. The artery's diameter was measured with ultrasonography. After removal of the introducer-sheath a chitosan acetate dressing was applied on the wound and held in place with manual compression for 10 minutes. On 12 arteries successful hemostasis was reached. On 2 arteries, however, the hemorrhage was uncontrollable and led to a hypovolemic shock during the 10 minutes of manual compression. Possible causes of the negative outcome in 2 dogs were their old age and an introducer-sheath with a relatively or absolutely too large diameter. Chitosan acetate dressing was easy to use and the artery stayed patent. Dogs could walk directly after the recovery from anesthesia and their femoral artery were saved. As conclusion, the outer diameter of the introducer-sheath should not exceed 3 mm or the inner diameter of the artery.