Transarterial coil embolization of the internal and external carotid and maxillary arteries for prevention of hemorrhage from guttural pouch mycosis in horses

Objectives-To develop a transarterial coil embolization technique for occlu sion of the internal carotid artery (ICA), external carotid artery (ECA), a nd maxillary arteries (MA) in normal horses and to evaluate this technique for prevention of hemorrhage in horses affected with guttural pouch mycosis . Animals-Ten adult, normal horses and 4 horses with guttural pouch mycosis. Methods-All horses had transarterial coil embolization of the rostral and c audal ICA, caudal MA, and rostral EGA. In I affected horse, an aberrant act ively bleeding branch of the ECA was also occluded. Normal horses had a pre mortem angio,sram, and were killed either at 1 or 2 weeks or 1, 2, or 3 mon ths after the procedure. Specimens from the ICA, ECA and MA were evaluated by light microscopy. Results-No surgical complications were observed, except 1 horse that develo ped laryngeal hemiplegia and 1 pilot horse that had embolization of the cer ebral arterial circle. In normal horses, premortem angiography confirmed co mplete occlusion of all vessels, and coils were positioned as intended. All normal horses had partially maturing to mature, continuous thrombi occludi ng at the coils. In affected horses, no further episodes of epistaxis were observed. By day 60, all mycotic plaques had resolved without further treat ment. Ophthalmic complications were not observed. Conclusion-Transarterial embolization provided a safe, rapid, and effective method for ICA, EGA, and MA occlusion in normal and affected horses. In af fected horses, the technique was possible despite active bleeding, allowing adequate identification and occlusion of all sources of hemorrhage. (C) Co pyright 2000 by The American College of Veterinary Surgeons.