Peer-reviewed veterinary case report
Complications of balloon catheterization associated with aberrant cerebral arterial anatomy in a horse with guttural pouch mycosis.
- Journal:
- Veterinary surgery : VS
- Year:
- 1998
- Authors:
- Bacon Miller, C et al.
- Affiliation:
- Department of Veterinary Medicine and Surgery · United States
- Species:
- horse
Plain-English summary
A 3-year-old Quarter Horse gelding was treated for a fungal infection in the left guttural pouch, which is an air-filled space near the throat, by blocking and using a balloon catheter in the left internal carotid artery. The catheter did not go in as far as usual, and during the procedure, it was seen moving through the artery in the guttural pouch. After the procedure, the horse had trouble breathing, did not wake up, developed fluid in the lungs, and sadly died about 5.5 hours later. A postmortem exam showed that the artery had an unusual path, and the catheter had ended up in a dangerous location in the brain. The findings suggest that if abnormal blood vessel branches are not detected and treated properly, it can lead to serious complications, including bleeding and brain damage. Unfortunately, the treatment did not work, and the horse passed away.
Abstract
A 3-year-old Quarter Horse gelding was treated for left guttural pouch mycosis by ligation and balloon catheterization of the left internal carotid artery. Catheter advancement was shorter (10 cm) than the normally reported distance (13-15 cm), but was observed endoscopically during placement as it coursed within the internal carotid artery through the guttural pouch. The horse developed a persistently abnormal respiratory pattern after catheter placement, failed to gain consciousness, developed pulmonary edema, and died 5.5 hours postoperatively. Postmortem examination revealed an aberrant left internal carotid arterial course with location of the embolectomy catheter at the junction of the basilar and caudal cerebellar arteries. Brainstem neuronal necrosis and alveolar and interstitial pulmonary edema were identified on histological examination. Angiography may be used to identify aberrant branching patterns. Failure to identify and occlude aberrant branches may result in fatal epistaxis and Brainstem lesions.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/9749516/