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Ultrasound guided transarterial coil placement in the internal and external carotid artery in horses
Juan Muñoz1, Manuel Iglesias, Eduardo Lloret Chao
1Alfonso X el Sabio Veterinary School, Villanueva de la Cañada, Spain.
Insights
Ultrasound-guided transarterial coil placement (UGTACP) is a feasible alternative for equine carotid artery occlusion, offering accurate catheterization and reduced radiation exposure when combined with fluoroscopy.
Area of Science:
- Veterinary Surgery
- Interventional Radiology
- Equine Medicine
Background:
- Traditional methods for equine carotid artery occlusion often rely on fluoroscopy, which involves radiation exposure.
- Assessing minimally invasive techniques for internal carotid artery (ICA) and external carotid artery (ECA) occlusion is crucial for equine health.
Observation:
- This study evaluated ultrasound-guided transarterial coil placement (UGTACP) in equine cadavers and live horses.
- The procedure involved catheterizing the caudal portions of the ICA and ECA, with ICA coil placement in the rostral part performed blindly and confirmed radiographically.
Findings:
- Accurate ultrasound-guided catheterization of the ICA and ECA was achieved in all specimens.
- UGTACP was successful in nearly all cases, with no complications in the in vivo study.
- A clinical case of guttural pouch mycosis treated with UGTACP fully recovered.
Implications:
- UGTACP presents a viable, fluoroscopy-sparing alternative for equine carotid artery occlusion.
- The technique allows for precise catheterization and identification of arterial anomalies.
- Combining ultrasound and fluoroscopy may minimize radiation exposure in clinical applications.
Objectives:
To assess ultrasound guided transarterial coil placement (UGTACP) for occlusion of the internal carotid artery (ICA) and external carotid artery (ECA) in horses.
Study Design:
Cadaveric and in vivo study.
Animals:
Cadaveric horses (n = 10), healthy horses (3), and 1 clinical case.
Methods:
Cadaveric and in vivo (healthy horses): UGTACP was performed in the caudal part of the ICA and ECA. Coil placement in the rostral part of the ICA was performed blindly and controlled by conventional radiography. No coils were placed in the rostral part of the ECA.
Clinical Case:
UGTACP of the ICA was in a horse with guttural pouch mycosis of the left guttural pouch.
Results:
Accurate ultrasound-guided catheterization of the ICA and ECA was performed in all specimens. Ultrasound-guided coil placement was successfully performed in all cases except 1. No complications occurred in the in vivo study. The clinical case fully recovered and returned to its intended use.
Conclusions:
Based on our study, UGTACP of the ICA and ECA caudal part is a feasible alternative to fluoroscopy. An advantage of this technique is the accuracy with which you can catheterize both ICA and ECA and the ability to identify unusual branching at the origin of the ICA. Regarding the rostral part of the ICA, angiographic catheter guidance in this region is probably more precise using fluoroscopy as it is performed blindly. In a clinical situation, combination of US and fluoroscopy guidance can result in reduction of radiation exposure time.
