Challenges associated with the diagnosis and management of guttural pouch epistaxis in equids

Lepage, Olivier

doi:10.1111/eve.12533

Cited by 10 publications

(14 citation statements)

References 30 publications

(43 reference statements)

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“…Other limitations of standing procedures include movement of the horse as a result of ataxia or insufficient analgesia, which may lead to an increased risk to staff and material. A report on guttural pouch mycosis described two horses that collapsed during standing transarterial coil embolization, 24 and severe ataxia was also reported in one of our clinical cases, requiring general anesthesia to safely finish the surgery. It may also be more difficult to maintain asepsis of the surgical field than in a recumbent horse, mainly because of horse movements.…”

Section: Discussionsupporting

confidence: 51%

“…[20][21][22][23] In those reports, horses were euthanatized or died of their neurological disorders; intraoperative diagnosis may have prevented these dramatic outcomes. Lepage 24 also reported collapse in two cases during transarterial coil embolization and supposed it might be linked to transitory reduced blood flow of ischemia induced by a spasm of the arteries.…”

Section: Discussionmentioning

confidence: 97%

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Balloon catheter occlusion of the maxillary, internal, and external carotid arteries in standing horses

et al. 2021

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Objective: To assess the feasibility of balloon catheter occlusion of the internal carotid artery (ICA), external carotid artery (ECA), and maxillary artery (MA) in standing horses. Study design: Experimental and clinical cases series. Animals: Eight healthy horses (phase 1) and 11 clinical cases (phase 2). Methods: Occlusions were performed on standing horses under sedation and local anesthesia. In phase 1, four horses underwent bilateral ICA balloon catheter occlusion, and four horses underwent balloon catheter occlusion of the ECA and MA. In phase 2, horses were treated by occlusion of ICA (n = 7), ECA (n = 2), or ECA and ICA (n = 2). Results: Internal carotid artery occlusion was successful in seven of eight and seven of nine arteries in phases 1 and 2, respectively. The procedures lasted 53 and 50 minutes, respectively, and catheters were inserted over 13 ± 0.7 cm (mean ± SD). External carotid artery occlusion was successful in seven of seven and four of four arteries in phases 1 and 2, respectively, with mean durations of 31 and 26 minutes, respectively, and a mean distance of catheter insertion of 11.9 cm. Maxillary artery occlusion was successful in five of seven arteries (phase 1), with a mean surgical duration of 47 minutes and a mean distance of catheter insertion of 42.8 cm. Conclusion: Balloon catheter occlusion of the ICA, ECA, and MA was achieved in most standing horses. Clinical significance: Balloon catheter occlusion in standing horses provides an alternative to prevent or treat hemorrhage related to guttural pouch mycosis, particularly in horses in which general anesthesia might pose a risk. 1 | INTRODUCTION Guttural pouch mycosis is a rare disease of the horse without apparent age, sex, and breed predisposition. 1,2 Hemorrhage related to guttural pouch mycosis is a life-threatening pathology commonly treated surgically by arterial occlusion, which is performed with ligation, embolization, or both. Various materials have been described for vascular embolization, such as balloon tipped catheter, 1,3,4 detachable selfsealing latex balloon, 5 transarterial coil, 6 or nitinol plug. 7 Unlike coil insertion, 8,9 balloon catheter occlusion

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 97%

Balloon catheter occlusion of the maxillary, internal, and external carotid arteries in standing horses

et al. 2021

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“…; Rush and Mair ; Pollock ; Freeman and Hardy ). However, no complications were described in a 2‐year follow‐up study of 31 horses after transarterial coil embolisation (Lepage and Piccot‐Crezollet ; Pollock ; Lepage ).…”

Section: Introductionmentioning

confidence: 99%

“…Complications associated with the use of balloon-tipped catheters include failure of the balloon to remain inflated, catheter breakage, incisional infection and wound breakdown (Freeman and Donawick 1980a;Caron et al 1987;Rush and Mair 2004;Pollock 2007;Freeman and Hardy 2012). However, no complications were described in a 2-year follow-up study of 31 horses after transarterial coil embolisation (Lepage and Piccot-Crezollet 2005;Pollock 2007;Lepage 2016). Surgical site infection was described at 5 and 44 days after occlusion of the ICA with a balloon-tipped catheter in clinical cases (Freeman and Donawick 1980a).…”

Section: Introductionmentioning

confidence: 99%

Surgical site infection after occlusion of the internal carotid artery with a thrombectomy catheter: Five cases

Jennings

Lepage

Mair

et al. 2017

Equine Veterinary Education

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Summary Although rare, guttural pouch mycosis is a potentially life‐threatening disease in the horse. The disease is most commonly treated surgically. One surgical option is occlusion of the internal carotid artery with a combination of ligation and use of a balloon tipped venous thrombectomy catheter. Complications of such treatment are rarely reported. This case series of five individuals describes the appearance, diagnosis and management of medium (>2 weeks) and long‐term (>10 years) complications (including abscess formation, draining sinuses and wound dehiscence) of internal carotid artery occlusion with a venous thrombectomy catheter and management of these surgical site infections. The clinical presentations included swelling and/or discharging tracts in the parotid region. In one horse, an osseous reaction of the basisphenoid bone and penetration of the contralateral guttural pouch by the implant were identified by computed tomography. In all five horses, the surgical site infections were successfully resolved following removal of the venous thrombectomy catheter.

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“…[6] The gold standard for detection of guttural pouch disease in most cases is endoscopy [4,5] , however in cases of guttural pouch mycosis, it is often only performed once the mycotic plaques have established over and began to erode the internal carotid artery, external carotid artery or maxillary artery causing moderate to severe epistaxis [5][6][7] . Horses can have multiple or a single episode of haemorrhage before a fatal episode can occur [5][6][7][8] highlighting the importance and urgency of diagnosis, treatment and management of guttural pouch disease.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the effect of laser salpingopharyngostomy on the guttural pouch environment in horses

Jukic

Cowling

Perkins

et al. 2020

Equine Veterinary Journal

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Challenges associated with the diagnosis and management of guttural pouch epistaxis in equids

Cited by 10 publications

References 30 publications

Balloon catheter occlusion of the maxillary, internal, and external carotid arteries in standing horses

Balloon catheter occlusion of the maxillary, internal, and external carotid arteries in standing horses

Surgical site infection after occlusion of the internal carotid artery with a thrombectomy catheter: Five cases

Evaluation of the effect of laser salpingopharyngostomy on the guttural pouch environment in horses

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