Abstract
Objective The aim of this study was to describe a simple and effective method to control severe
haemorrhage from intraoperative trauma to the cranial tibial artery (CTA) during tibial
plateau levelling osteotomy (TPLO) and to report long-term outcomes.
Study Design Cadaveric descriptive study and retrospective case series. A TPLO was performed in
eight cadaveric limbs, followed by intentional laceration of the CTA under fluoroscopic
guidance. Dissection of the limb was performed and the relationship between the CTA
and the surrounding structures was evaluated. A computed tomography angiogram was
performed following TPLO in one cadaveric limb. Medical records from cases that had
intraoperative arterial bleeding between 2015 and 2019 were reviewed. Cases were included
if bleeding was controlled by following the usual steps for TPLO. Radiographic follow-up
6 to 10 weeks postoperatively and long-term follow-up owner's questionnaire were available.
Results During TPLO, the CTA is tightly compressed between the caudal aspect of the proximal
tibia and the popliteal musculature. Rotation and compression of the proximal tibia
followed by closure of the pes anserinus successfully controlled arterial bleeding
during TPLO in nine clinical cases without the need for direct ligation.
Conclusion Continuing the usual steps of a TPLO can successfully control intraoperative bleeding
from the CTA with no long-term complications. This technique should be considered
in cases of arterial bleeding during TPLO before direct ligation.
Keywords tibial plateau levelling osteotomy - cranial tibial artery - bleeding - cadaveric
- angiography
