Axillary artery: In some instances, the
axillary may be the preferred artery. An
example is deep hypothermic arrest. A through
and through technique is best. After a
generous skin wheal of local anesthetic,
use the left hand to immoblize the artery
and place an IV thru both walls of the
artery. Remove the needle and withdraw the
catherter till blood spurts out. Then pass
a guide wire. If a small (.021 in) wire is
used, it is possible for the catheter to
fold at its junction with the artery.
The catheter may appear to thread
but will not go interarterial. To test for
this possibility, pull back on the guide
wire after the catherter is in a small
way. If folding has occured, the wire will
be very difficult to remove. Also be sure
about the compatibility of the guide wire
and the catheter. After the catheter is
in place, any flushing of the catheter
must be done very carefully. It is
possible to flush clots and air in a
retrograde fashion into the cerebral
circulation and cause a CVA.