Transarterial coil embolisation in 31 horses (1999-2002) with guttural pouch mycosis: a 2-year follow-up.
Authors: Lepage O M, Piccot-Crézollet C
Journal: Equine veterinary journal
Summary
# Editorial Summary: Transarterial Coil Embolisation for Guttural Pouch Mycosis Guttural pouch mycosis (GPM) presents a significant clinical challenge in equine practice, particularly when haemorrhage or neurological compromise develops; this retrospective case series examined 31 horses treated exclusively with transarterial coil embolisation (TCE) between 1999 and 2002, with follow-up extending 24–41 months post-procedure. The cohort included horses with unilateral or bilateral disease affecting the medial, lateral or both compartments, allowing evaluation of TCE efficacy across varied presentations. Among 23 horses presenting with epistaxis, 20 achieved complete resolution; whilst 19 horses with neurological signs showed generally favourable outcomes, only 2 required euthanasia due to persistent severe dysphagia. Overall survival rates reached 84%, with 71% of treated horses returning to the level of work expected by owners or trainers, and notably, no cases of mycotic relapse were documented during the extended follow-up period. These findings suggest TCE is a highly effective interventional technique for haemorrhage control and lesion resolution in GPM, offering an alternative to more invasive approaches and potentially eliminating the need for concurrent medical or surgical therapies—though practitioners should remain aware that neurological sequelae may persist in a subset of cases despite successful embolisation.
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Practical Takeaways
- •TCE is an effective first-line treatment for guttural pouch mycosis with excellent long-term outcomes and no recurrence during extended follow-up
- •Epistaxis related to GPM responds well to TCE alone without requiring additional medical or surgical intervention in most cases
- •Horses with severe neurological complications (particularly dysphagia) may have a guarded prognosis despite intervention
Key Findings
- •Transarterial coil embolisation achieved 84% survival rate and 71% return to expected performance level in 31 horses with guttural pouch mycosis
- •Of 23 horses presenting with epistaxis, 20 (87%) showed complete resolution following TCE treatment
- •No relapse of mycosis occurred during 24-41 month follow-up period in any treated horse
- •Two horses with severe persistent dysphagia required euthanasia despite treatment