Ultrasound-guided injection of the median artery in the standing sedated horse.
Authors: Spriet M, Trela J M, Galuppo L D
Journal: Equine veterinary journal
Summary
# Editorial Summary: Ultrasound-Guided Median Artery Injection in Standing Horses Intra-arterial injection of therapeutic agents such as mesenchymal stem cells achieves superior distribution and persistence in equine limbs compared with intravenous regional perfusion, but has previously required general anaesthesia due to technical complexity. Spriet and colleagues investigated whether ultrasound guidance could enable median artery injection in standing, sedated horses, comparing catheter placement against direct needle injection across six horses (twelve limbs). Catheter placement succeeded in all limbs but proved problematic in practice: arterial spasm prevented injection in one case, and limb movement caused loss of catheter function in two others; in contrast, direct needle injection achieved successful injection in all six limbs, with periarterial extravasation noted in only two cases and no clinical complications observed. Direct needle injection emerged as the more practical approach, being technically simpler and less likely to provoke vasospasm than catheterisation. These findings open possibilities for delivering intra-arterial therapies—particularly stem cell treatments—under standing sedation rather than general anaesthesia, potentially reducing anaesthetic risk whilst improving treatment efficacy through superior drug distribution.
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Practical Takeaways
- •Direct needle injection technique is more practical than catheterisation for median artery injection in standing horses, with better reliability and lower risk of arterial spasm
- •Standing sedated median artery injection offers an alternative to general anaesthesia for intra-arterial therapeutic delivery such as mesenchymal stem cells
- •Periarterial extravasation remains a concern; careful ultrasound-guided technique and post-procedure monitoring are essential
Key Findings
- •Catheter placement successful in all 6 limbs but injection failed in 1 due to arterial spasm and lost functionality in 2 others due to limb movement
- •Direct needle injection was successful in all 6 limbs with periarterial extravasation observed in 2 limbs
- •No clinical complications were observed post-procedure
- •Median artery injection is feasible in standing sedated horses under regional analgesia with ultrasound guidance