Potential for iatrogenic coil embolization of the caudal cerebellar artery during treatment of internal carotid artery bifurcation in two horses with guttural pouch mycosis

Bonilla, Alvaro G.; Scansen, Brian A.; Hurcombe, Samuel D.A.; Mudge, Margaret C.

doi:10.2460/javma.247.12.1427

Cited by 12 publications

(17 citation statements)

References 17 publications

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“…With description of ultrasound-guided centesis of CSF in standing horses [114] and updated CT technology, standing CT myelography is a potential future application. Also, with standing fluoroscopic angiography of the guttural pouch region [115,116], the variation in carotid artery branches [117] and the potential for inadvertent coil embolisation [118], standing contrast-enhanced CT offers improved evaluation of guttural pouch mycosis without risking fatal haemorrhage that could occur after the horse is anaesthetised.…”

Section: Techniques/usesmentioning

confidence: 99%

Use of contrast media in computed tomography and magnetic resonance imaging in horses: Techniques, adverse events and opportunities

Nelson

Goodrich

Barrett

et al. 2017

Equine Veterinary Journal

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The use of contrast media in computed tomography (CT) and magnetic resonance imaging (MRI) is increasing in horses. These contrast-enhanced imaging techniques provide improved tissue delineation and evaluation, thereby expanding diagnostic capabilities. While generally considered safe, not all contrast media exhibit the same safety profiles. The safety of contrast media use and descriptions of adverse events occurring in horses are sparsely reported. This review summarises the reported evidence of contrast media use and adverse events that occur in horses, with added contribution from other veterinary species and studies in man for comparison. This comprehensive data set empowers equine clinicians to develop use and monitoring strategies when working with contrast media. Finally, it summarises the current state-of-the-art and highlights the potential applications of contrast-enhanced CT and MRI for assessment of diseased or injured equine tissues, as well as (patho)physiological processes.

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Section: Techniques/usesmentioning

confidence: 99%

Use of contrast media in computed tomography and magnetic resonance imaging in horses: Techniques, adverse events and opportunities

Nelson

Goodrich

Barrett

et al. 2017

Equine Veterinary Journal

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“…However, similar neurological disorders have also been reported with unilateral occlusion. [20][21][22][23] In those reports, horses were euthanatized or died of their neurological disorders; intraoperative diagnosis may have prevented these dramatic outcomes. Lepage 24 also reported collapse in two cases during transarterial coil embolization and supposed it might be linked to transitory reduced blood flow of ischemia induced by a spasm of the arteries.…”

Section: Discussionmentioning

confidence: 99%

Balloon catheter occlusion of the maxillary, internal, and external carotid arteries in standing horses

et al. 2021

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Objective: To assess the feasibility of balloon catheter occlusion of the internal carotid artery (ICA), external carotid artery (ECA), and maxillary artery (MA) in standing horses. Study design: Experimental and clinical cases series. Animals: Eight healthy horses (phase 1) and 11 clinical cases (phase 2). Methods: Occlusions were performed on standing horses under sedation and local anesthesia. In phase 1, four horses underwent bilateral ICA balloon catheter occlusion, and four horses underwent balloon catheter occlusion of the ECA and MA. In phase 2, horses were treated by occlusion of ICA (n = 7), ECA (n = 2), or ECA and ICA (n = 2). Results: Internal carotid artery occlusion was successful in seven of eight and seven of nine arteries in phases 1 and 2, respectively. The procedures lasted 53 and 50 minutes, respectively, and catheters were inserted over 13 ± 0.7 cm (mean ± SD). External carotid artery occlusion was successful in seven of seven and four of four arteries in phases 1 and 2, respectively, with mean durations of 31 and 26 minutes, respectively, and a mean distance of catheter insertion of 11.9 cm. Maxillary artery occlusion was successful in five of seven arteries (phase 1), with a mean surgical duration of 47 minutes and a mean distance of catheter insertion of 42.8 cm. Conclusion: Balloon catheter occlusion of the ICA, ECA, and MA was achieved in most standing horses. Clinical significance: Balloon catheter occlusion in standing horses provides an alternative to prevent or treat hemorrhage related to guttural pouch mycosis, particularly in horses in which general anesthesia might pose a risk. 1 | INTRODUCTION Guttural pouch mycosis is a rare disease of the horse without apparent age, sex, and breed predisposition. 1,2 Hemorrhage related to guttural pouch mycosis is a life-threatening pathology commonly treated surgically by arterial occlusion, which is performed with ligation, embolization, or both. Various materials have been described for vascular embolization, such as balloon tipped catheter, 1,3,4 detachable selfsealing latex balloon, 5 transarterial coil, 6 or nitinol plug. 7 Unlike coil insertion, 8,9 balloon catheter occlusion

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“…It also eliminates the opportunity to perform a contrast study on the occluded artery because access to that artery is impeded by the presence of the balloon and catheter shaft. Although the lack of fluoroscopic guidance is a limitation, the actual prevalence of aberrant or unusual branches might be low enough (Bonilla et al 2015;Khairuddin et al 2015) to make this risk acceptable if no other option is available. One of the disadvantages of the balloon catheter is the need for a more invasive cut-down to access the affected artery and, in some cases, many arteries, to achieve complete occlusion when the source of haemorrhage is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Although the lack of fluoroscopic guidance is a limitation, the actual prevalence of aberrant or unusual branches might be low enough (Bonilla et al . ; Khairuddin et al . ) to make this risk acceptable if no other option is available.…”

mentioning

confidence: 99%

Surgical site infection after occlusion of the internal carotid artery with a thrombectomy catheter: Can this be prevented?

Freeman

2017

Equine Veterinary Education

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Summary Based on available evidence, the embolisation methods guided by fluoroscopy (nitinol plugs and transarterial coil embolisation) are preferred when available to occlude the bleeding artery in horses with guttural pouch mycosis. All attempts should be made to submit suitable candidates to hospitals with the necessary equipment and expertise for these procedures. However, when this opportunity is not available, the nondetachable balloon catheter could still offer a viable and effective alternative. Although the risk of surgical site infection is a delayed complication of this method, risk of infection can be reduced by planned removal at 10–14 days after catheter placement.

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Potential for iatrogenic coil embolization of the caudal cerebellar artery during treatment of internal carotid artery bifurcation in two horses with guttural pouch mycosis

Cited by 12 publications

References 17 publications

Use of contrast media in computed tomography and magnetic resonance imaging in horses: Techniques, adverse events and opportunities

Use of contrast media in computed tomography and magnetic resonance imaging in horses: Techniques, adverse events and opportunities

Balloon catheter occlusion of the maxillary, internal, and external carotid arteries in standing horses

Surgical site infection after occlusion of the internal carotid artery with a thrombectomy catheter: Can this be prevented?

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