Surgical thrombectomy in horses with aortoiliac thrombosis: 17 cases.
Abstract: Aortoiliac thrombosis (AIT) is a progressive vascular disease characterised by an exercise-induced hindlimb lameness. After developing a surgical technique, a follow-up study was required. Objective: To assess the surgical results of a surgical thrombectomy in horses with AIT, a chronic arterial occlusive disease of the aorta and its caudal arteries. Methods: Seventeen cases showed the typical signs of AIT and diagnosis was confirmed by Doppler-ultrasonography. Average age of the horses was 12 years. Seven stallions, 6 mares and 4 geldings were included. Results: The thrombus was located in the left hindlimb (5 cases), the right hindlimb (9 cases) or in both hindlimbs (3 cases). Two cases were operated on both limbs with a few days between surgeries. Nine (53%) horses regained their athletic performance and 2 horses were able to work for at least 30 min without complaint, instead of the initial 5 min prior to surgery. During surgery one horse had to be subjected to euthanasia because the thrombus was too tightly attached to the arterial wall and could not be removed. Two horses were subjected to euthanasia post operatively due to severe myopathy and one due to a femoral fracture during recovery. Two reocclusions of the treated artery occurred 4 months after surgical intervention: one horse was reoperated and, due to the extent of the thrombus and quality of the arterial wall, the horse was subjected to euthanasia; the other horse was subjected to euthanasia without a second surgery. A severe complication was the appearance of AIT in the contralateral limb after surgery as result of occlusion caused by an embolus loosened by the procedure. Post anaesthetic myopathy was seen in 4 (24%) of the cases and could be so severe that euthanasia had to be considered. Conclusions: Surgical intervention by means of a thrombectomy in horses with AIT should be considered; 65% of the horses regained athletic activity and 53% of the operated horses in this study performed at their previous level. Adequate padding, correct positioning, prevention of intraoperative hypotension and keeping surgery time as short as possible, are important parameters to prevent post operative myopathy.
Publication Date: 2010-01-26 PubMed ID: 20095222DOI: 10.2746/042516409x422939Google Scholar: Lookup
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Summary
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This study evaluates the results of surgical thrombectomy on horses diagnosed with aortoiliac thrombosis (AIT), a chronic arterial blockage affecting the aorta and its lower arteries causing hindlimb lameness when exercising. Overall, the surgery was successful on 65% of the cases, with over half of them regaining their previous athletic performance level.
Methodology
- The researchers studied 17 horses showing signs of AIT, with diagnosis confirmed by Doppler-ultrasonography.
- The horses, with an average age of 12 years, comprised of seven stallions, six mares and four geldings.
Results
- Of the cases observed, the location of the thrombus (blood clot) was diverse: five were in the left hindlimb, nine in the right, and three were in both hindlimbs.
- In two cases, both hindlimbs needed intervention, with surgeries spaced out over a few days.
- Following surgery, nine horses, which constitutes 53% of the cases, regained their normal athletic performance.
- Two other horses, post-surgery, were able to perform without complaint for 30 minutes, in contrast to a mere 5 minutes pre-surgery.
- There were some complications however; one horse needed to be euthanised mid-surgery, the thrombus being too tightly bound to the arterial wall for removal.
- Post-operation, two more were euthanised due to severe myopathy (muscle disease), and another one due to a resultant femoral fracturing.
Post-operative Complications and Interventions
- In the 4 months after surgical intervention, arterial reocclusions occurred in two horses; one of the horses was reoperated but had to be euthanised resulting from the size of the thrombus and the condition of the arterial wall, while the other was euthanised without a second attempt at surgery.
- A severe complication was the development of AIT in the opposite limb, resulting from a loosened embolus (clot) during the procedure.
- Post-anaesthetic myopathy was seen in four cases, in certain scenarios severe enough to consider euthanasia.
Conclusion
- The evidence shows that surgical thrombectomy should be considered for horses with AIT; 65% of the horses in the study regained athletic activity, and 53% of those operated on returned to their previous performance level.
- Preventive measures, such as proper padding, correct horse positioning during surgery, monitoring to prevent intraoperative hypotension, and reduced surgery time may help to alleviate post-operative myopathy in future cases.
Cite This Article
APA
Rijkenhuizen AB, Sinclair D, Jahn W.
(2010).
Surgical thrombectomy in horses with aortoiliac thrombosis: 17 cases.
Equine Vet J, 41(8), 754-758.
https://doi.org/10.2746/042516409x422939 Publication
Researcher Affiliations
- Department of Equine Sciences, Utrecht University, Yalelaan 114, 3584CM Utrecht, The Netherlands.
MeSH Terms
- Animals
- Aorta, Abdominal / surgery
- Aortic Diseases / surgery
- Aortic Diseases / veterinary
- Arterial Occlusive Diseases / surgery
- Arterial Occlusive Diseases / veterinary
- Female
- Femoral Artery / surgery
- Horse Diseases / surgery
- Horses
- Male
- Thrombectomy / veterinary
- Thrombosis / surgery
- Thrombosis / veterinary
Citations
This article has been cited 2 times.- Michaud CR, Herbert R, Elkins WR, Gozalo AS. Acute Occlusion of the Abdominal Aorta with Sudden Paraplegia in a Captive Mustached Tamarin (Saguinus mystax). Comp Med 2017 Oct 1;67(5):456-460.
- Spriet M, Vandenberghe F. Equine Nuclear Medicine in 2024: Use and Value of Scintigraphy and PET in Equine Lameness Diagnosis. Animals (Basel) 2024 Aug 28;14(17).
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