Q: 69 year old male is admitted to ICU for frequent dizziness. After workup, surgery has been consulted for  Carotid Endarterectomy (CEA). Which artery should be selected for cannulation in patients going for CEA?


Answer: 

Patients going for CEA by default have systemic atherosclerotic disease, and difference in blood pressure measurement is frequent in different arms. The arm with the higher cuff blood pressure should be choosen for "A-line". If radials are not readily palpable or cannot be cannulated, the femoral artery with higher cuff blood pressure in corresponding lower extremity should be cannulated.


Reference:

Frank SM, Norris EJ, Christopherson R, Beattie C. Right- and left-arm blood pressure discrepancies in vascular surgery patients. Anesthesiology 1991; 75:457.