[Percutaneous occlusion of arterial vessels using permanent embolization for the treatment of an air sac hemorrhage in horses. A case report].

The research discusses a case where a severe guttural pouch hemorrhage in a horse was treated successfully by using an innovative procedure of blockading, or occluding, the damaged blood vessels through intravascular embolisation systems without requiring direct surgery.

Study Methodology and Findings

• The first step involved Percutaneous catheterisation of the common carotid artery, which allowed the research team to visualize the main arteries of the horse’s head, namely the external carotid, internal carotid, and the occipital arteries, via angiography. No irregularities were spotted via this procedure.
• Further analysis showed an artery originating from the occipital artery that led to numerous, extensively branched, and winding vessels extending to the guttural pouch area. The structure was linked to inflammatory hypervascularization, an abnormal increase in blood flow to an area due to inflammation.
• To stop the hemorrhage, the artery was blocked by placing a detachable balloon just downstream of where the two small vessels branched out. This was followed by the insertion of two coil implants into the occipital artery just upstream of the origin of this artery, thus completing the embolisation or blockage.

Occlusion and Post Procedure Updates

• Blockage of the distal part of the artery was essential to prevent a blood supply to the bleeding lesion from the opposite side of the arterial system via the circle of Willis, a circulatory anastomosis in the brain.
• The employed technique efficiently barred the targeted head artery without the need for direct surgical interference in the area. Therefore, the implants need not to be removed post-blockage.
• After this procedure, the horse did not encounter any more episodes of nose bleeding (epistaxis).
• The underlying inflammatory condition in the guttural pouch, caused by a diphtheroid infection, was managed by local infusions of iodine solutions and completely healed within a 24 day period.