Coil embolization of a palatine artery pseudoaneurysm in a gelding.
Authors: McClellan Nathaniel R, Mudge Margaret C, Scansen Brian A, Jung Stephen S, Russell Duncan
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Coil Embolization of Palatine Artery Pseudoaneurysm in an Equine Case Severe, persistent epistaxis in horses can prove diagnostically challenging and clinically intractable, particularly when conventional treatments fail to identify a specific bleeding source. This 2014 case report documents the successful management of a 24-year-old Morgan gelding presenting with right-sided epistaxis caused by a palatine artery pseudoaneurysm extending into the caudal maxillary sinus, employing a minimally invasive interventional radiology technique not commonly reported in equine practice. After localising the lesion via radiography, computed tomography, sinoscopy and angiography, the veterinary team performed transarterial coil embolization via the common carotid artery, successfully occluding the bleeding vessel without surgical incision into the sinus itself. Post-operative recovery was uncomplicated in the immediate term—the horse remained epistaxis-free for two months following discharge—though mild nasal discharge and intermittent coughing were noted. This case demonstrates that transarterial coil embolization represents a viable, less invasive alternative to conventional surgical approaches for managing major arterial haemorrhage in equine nasal and sinus disease, particularly when the pseudoaneurysm is amenable to catheterisation; however, practitioners should recognise this technique requires specialist equipment, imaging capability and interventional training not available at most equine facilities.
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Practical Takeaways
- •Transarterial coil embolization is a viable minimally invasive alternative to surgical ligation for managing severe epistaxis from palatine artery pseudoaneurysms
- •Advanced imaging (CT and angiography) is essential for precisely locating the bleeding source before attempting intervention
- •Consider this technique when severe epistaxis is unresponsive to conservative management or when surgical access to the maxillary sinus is difficult
Key Findings
- •Transarterial coil embolization successfully occluded a ruptured palatine artery pseudoaneurysm in a 24-year-old gelding
- •No epistaxis recurrence was observed in the 2-month postoperative follow-up period before unrelated colic death
- •CT and necropsy confirmed successful placement of embolization coils in the right palatine artery