The human femoral artery can bleed dangerously following the removal of a catheter during cardiac catheterization. In this study, a modified technique of needle insertion, simply inserting the needle bevel-down instead of the standard bevel-up approach, was tested as a means to reduce bleeding after catheter removal. Large bore needle punctures were made in surgically exposed arteries of anesthetized pigs using either a standard technique (45 degree approach, bevel up) or a modified technique (25 degree approach, bevel down). For half the punctures, topical phenylephrine solution (1 mg/ml) was applied to the adventitia of the artery to cause constriction. Median bleeding rates were reduced from 81 to less than 1 ml/min/100 mmHg intraluminal pressure by the modified technique with application of phenylephrine. In most cases zero bleeding, that is self-sealing, of the arteries occurred. It is postulated that a flap-valve of tissue created by the modified technique produced this self-sealing behavior. Sophisticated modeling studies are needed to fully understand this new phenomenon.
Self-sealing, Large Bore Arterial Punctures: A Counterintuitive New Phenomenon
Contributed by the Bioengineering Division for publication in the JOURNAL OF BIOMECHANICAL ENGINEERING. Manuscript received October 2000; revised manuscript received April 2002. Associate Editor: J. D. Humphrey.
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Roeder, B. A., Babbs, C. F., Schoenlein, W. E., Kokini, K., and Sadeghi, F. (July 30, 2002). "Self-sealing, Large Bore Arterial Punctures: A Counterintuitive New Phenomenon ." ASME. J Biomech Eng. August 2002; 124(4): 342–346. https://doi.org/10.1115/1.1488935
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