Occlusion of internal carotid artery in the horse by means of a balloon-tipped catheter: clinical use of a method to prevent epistaxis caused by guttural pouch mycosis.

This research discusses a technique used to manage nosebleeds (epistaxis) caused by guttural pouch mycosis in horses, involving the use of a balloon-tipped catheter to block (occlude) the internal carotid artery. The two horses treated with this procedure showed no further signs of epistaxis and were able to resume training and racing.

Method and Procedure

• The researchers used an intravascular procedure, which involves working within the blood vessels, to treat the two horses experiencing nosebleeds from guttural pouch mycosis. Guttural pouch mycosis is a common condition in horses marked by fungal infection in the guttural pouch – an air-filled sac located in the horse’s upper respiratory tract.
• The procedure involved the use of a balloon-tipped catheter – a thin, flexible tube with a small balloon at the tip that can be inflated or deflated as needed. This catheter was introduced into the internal carotid artery of the affected horses.
• The internal carotid artery, a major blood vessel in the neck, was chosen for intervention as it supplies blood to the brain and the rest of the head. In each of the two horses, the artery was ligated (tied off) close to its origin point.
• The tip of the balloon-tipped catheter was moved across the site of infection within the artery, past the ligature. The balloon was then steadily inflated, effectively obstructing the artery and ensuring that the infected area was isolated from the rest of the horse’s cerebral vascular system, preventing the spread of the infection.

Results and Outcomes

• After using the balloon-tipped catheter to occlude the internal carotid artery, the two horses experienced no further instances of nosebleeds. This suggests that the procedure was successful in managing the symptoms of guttural pouch mycosis.
• The catheters inserted into the horses remained in place for different time periods. The first horse had the catheter removed after 14 days, while for the second horse, it was removed after 51 days. The variable removal times show that the duration of treatment can depend on individual circumstances and how well the horse is responding to the procedure.
• Following the successful procedure, both horses were able to return to their regular training and racing routines. This indicates that the balloon-tipped catheter approach not only effectively managed the symptoms of guttural pouch mycosis but also allowed the horses to return to their normal activities shortly after treatment.

Implications of the Study

• This research offers a promising solution for managing nosebleeds caused by guttural pouch mycosis in horses. Not only does it provide a practical intervention approach, but it also allows the horses to return to their regular activities soon after recovery, which is important for racing and working horses.
• The use of a balloon-tipped catheter to occlude the internal carotid artery is a minimally invasive procedure, reducing the risks associated with more invasive surgical approaches. Such procedures might be particularly useful in managing guttural pouch mycosis and other relevant conditions in horses.