Occlusion of the Internal Carotid Artery of Horses: Evaluation of a Technique Designed to Prevent Epistaxis Caused by Guttural Pouch Mycosis

In six, healthy, adult horses, the origin of the left internal carotid artery was isolated via a modified hyovertebrotomy approach. Normograde blood flow was occluded by placement of a tourniquet on the artery near its origin. Lumenal access was gained through placement of a distally directed introducer sheath and retrograde blood flow from the cerebral arterial circle was confirmed. An 8.5 mm diameter detachable latex balloon loaded onto a carrier catheter and placed within a guiding catheter was introduced into the internal carotid artery through the introducer sheath and advanced to the target occlusion site (the proximal curve of the sigmoid flexure of the internal carotid artery). The balloon was inflated with 0.5 ml of a radiopaque solution. Correct placement and inflation of the balloon were confirmed by intraoperative radiography. The balloon was then released and the guiding and carrier catheters withdrawn. Immediate embolization of the distal internal carotid artery was determined by lack of retrograde blood flow through the introducer sheath. The introducer sheath was withdrawn from the vessel and the proximal tourniquet was replaced with two ligatures. Horses were euthanized on day 30 and detailed gross and histopathologic examinations were performed.

The balloons were easily placed into the target site and produced immediate occlusion of retrograde flow from the cerebral arterial circle. All balloons remained inflated in their original position throughout the study period. Mature thrombus formation and absence of clinically significant inflammation were consistent findings in all occluded internal carotid arteries at gross necropsy and histologic examination.