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Equine veterinary journal2021; doi: 10.1111/evj.13506

Unilateral jugular vein stenosis in five horses and experience with percutaneous transluminal angioplasty.

Abstract: Venous stenosis, a possible cause of jugular dilatation and congestion, is well known in human medicine but has poorly been described in horses. Objective: To report unilateral jugular vein stenosis as a cause of jugular vein dilatation in horses and describe treatment by percutaneous transluminal angioplasty (PTA). Methods: Case report. Methods: Details of horses diagnosed with unilateral jugular stenosis were retrieved from medical records. Results: Five horses were presented with a non-painful, unilateral dilatation of the jugular vein of which two horses showed headshaking during exercise. In one horse an indwelling catheter had been used and jugular dilatation developed 4 weeks later. In the other horses, no intravenous injections had been administered in the months before jugular dilatation developed. Ultrasonographic examination revealed venous stenosis in all horses approximately 5-10 cm cranial to the thoracic inlet. The internal diameter at the level of this stenosis was only 1-3.1 mm. The length of the stenosis was about 15-19 mm with a markedly thickened intima and media on ultrasonography. After enoxaparin treatment, PTA was performed in three horses. During the procedure the stenotic vein was dilated three times with progressively increasing pressures up to 12 atm. The stenotic diameter increased to a maximum of 4.9 mm with improved jugular blood flow. Aftercare included anti-inflammatory and anti-thrombotic therapy. Conclusions: Jugular vein stenosis occurs in horses and should be included in the differential diagnoses of unilateral jugular vein dilatation. It may present in the absence of previous intravenous treatment. PTA of the jugular vein is feasible to improve jugular blood flow.
Publication Date: 2021-09-05 PubMed ID: 34486172DOI: 10.1111/evj.13506Google Scholar: Lookup
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Summary

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This article explores the case of five horses with unilateral jugular vein stenosis, expanding our understanding of the disease in horses. The study also details the effectiveness of treatment through percutaneous transluminal angioplasty.

Understanding the Research Objective

The paper presents an exploration into a veterinary condition—unilateral jugular vein stenosis in horses, which could result in jugular dilatation. The condition is well known in human medicine, but is less explored in equine species. The main objective of this research was to:

  • Recognize jugular vein stenosis as a cause of jugular dilatation in horses.
  • Document the treatment process using Percutaneous Transluminal Angioplasty (PTA).

Methodology Used in the Study

The study uses case report analysis. The medical records of horses diagnosed with unilateral jugular stenosis were retrieved and analyzed. Detailed observation of symptoms, progress, and treatment responses were recorded. The key approach involved:

  • Identifying horses presented with unilateral jugular vein dilatation.
  • Observing unique behaviors like headshaking during exercise.
  • Analyzing ultrasonographic examinations—specifically, looking for venous stenosis 5-10 cm cranial to the thoracic inlet.

Analysis of the Results

Within the five-horse sample, the paper records the varying symptoms and progression of the condition. The study found that in four of the five cases, no intravenous treatments had been administered before dilatation developed, suggesting that the condition was not necessarily caused by prior treatment. All the horses had a significantly narrow internal diameter at the level of stenosis which was between 1-3.1 mm and at its length was 15-19 mm with noticeably thickened intima and media on ultrasonography.

Overview of Treatment and Outcome

Three of the five horses underwent Percutaneous Transluminal Angioplasty (PTA) following enoxaparin treatment. In the procedure, the stenotic vein was deliberately expanded three times under increasing pressure of up to 12 atmospheres. The stenotic diameter after PTA ranged up to 4.9 mm, enhancing jugular blood flow. Post-treatment care involved anti-inflammatory and anti-thrombotic therapy.

Conclusion of the Study

Jugular vein stenosis is a recognized condition in horses and should be considered when diagnosing unilateral jugular vein dilatation. The disease can present itself without previous intravenous treatment, making it an independent condition. Based on the studied cases, PTA proves a feasible solution to improve blood flow in the jugular vein.

Cite This Article

APA
Paulussen E, Decloedt A, Vera L, Lefere L, van Loon G. (2021). Unilateral jugular vein stenosis in five horses and experience with percutaneous transluminal angioplasty. Equine Vet J. https://doi.org/10.1111/evj.13506

Publication

ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Paulussen, Ellen
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Decloedt, Annelies
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Vera, Lisse
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Lefere, Laurence
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
van Loon, Gunther
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Grant Funding

  • 1134917N / Research Fund Flanders

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