Trans-arterial coil embolization of the internal carotid artery in standing horses.

This study explores a method known as transarterial coil embolization (TACE) to block the internal carotid artery in horses, while they remain standing, as a means to prevent hemorrhage in those with guttural pouch mycosis (GPM). The study affirms the procedure to be safe, minimally invasive, and effective, with no complications related to the procedure observed during the study.

Methodology

• The researchers conducted a prospective study involving eight normal horses, and five horses with GPM.
• The TACE procedure was performed on the internal carotid artery of the horses in a standing position, under fluoroscopic guidance.
• Four of the normal horses were euthanized two weeks post TACE procedure for assessment of the morphological changes, and the rest were monitored for six months.
• The five clinically affected horses were evaluated for the success rate and any complications that may have arisen for a long-term period (10-12 months).

Results

• The protocol with TACE showed no complications, indicating that the procedure is safe.
• The injection of up to 30 milliliters of warmed meglumine ioxithalamate was well received by the horses.
• The procedure proved to be successful and effective, as confirmed by standing angiography, which showed complete occlusion of all vessels, and coils were positioned as intended.
• The local hemodynamics of the horses were not affected by the procedure.
• The researchers found maturation to mature continuous thrombi at the coil site after two weeks.
• Two of the clinically affected horses died on the 3rd and 12th day respectively, post-surgery due to other issues; however, the mycotic lesions were completely resolved in the three surviving horses without the need for further treatment.

Conclusion

• The researchers concluded that performing TACE under fluoroscopic guidance in standing horses is a safer, minimally invasive, and effective method for occluding the internal carotid artery.
• The procedure is recommended specifically for horses that are at risk under general anesthesia.
• Although the treatment may lead to residual neurological deficits, it does not indicate a failure of the procedure itself.