Purpose: To validate, in swine, the feasibility, efficacy, and safety of ultrasound (US)-guided vascular access, with manual compression for hemostasis, as an alternative to surgical cutdown.
Materials and methods: US-guided femoral vein access was attempted 22 times in eight pigs. Bilateral access was performed in the initial procedure (eight pigs, 16 veins), and unilateral access was performed during follow-up procedures (six pigs, six veins). Two sheath sizes were used: 9 F (in eight veins) and 8 F (in 14 veins). At the completion of each procedure, the vascular sheaths were removed and hemostasis was attempted by manual compression. All animals were followed clinically for at least 24 hours after each access procedure. Bilateral US images of the femoral region were obtained in six pigs (12 puncture sites) 2 weeks after the initial procedure.
Results: US-guided femoral vein access was successful in all 22 attempts, including 16 first-time insertions and six subsequent insertions. Hemostasis was achieved with 5 minutes of manual compression in all 22 procedures. No groin complications were identified on clinical follow-up or at necropsy. US imaging of the 12 femoral access points in the six pigs that underwent more than one procedure demonstrated normal femoral veins that compressed appropriately with no evidence of thrombosis or hematoma.
Conclusion: US-guided femoral vein access, with manual compression used for hemostasis, is a safe and effective method for venous interventions in swine. Moreover, this percutaneous technique allows the same vessel to be reused.