Unilateral jugular vein stenosis in five horses and experience with percutaneous transluminal angioplasty.
Authors: Paulussen Ellen, Decloedt Annelies, Vera Lisse, Lefere Laurence, van Loon Gunther
Journal: Equine veterinary journal
Summary
# Jugular Vein Stenosis in Horses: Recognition and Percutaneous Treatment Unilateral jugular vein dilatation in horses is typically attributed to thrombosis or catheter-related injury, yet venous stenosis—a well-established condition in human medicine—has received minimal attention in equine practice until now. Paulussen and colleagues examined five horses presenting with non-painful, unilateral jugular enlargement, two of which exhibited exercise-associated headshaking; whilst one case followed indwelling catheter use, the remaining animals had no documented preceding intravenous trauma. Ultrasonographic imaging revealed stenotic lesions (internal diameter 1–3.1 mm) located 5–10 cm cranial to the thoracic inlet, characterised by thickened intimal and medial layers spanning approximately 15–19 mm in length. Following enoxaparin treatment, three horses underwent percutaneous transluminal angioplasty (PTA), with sequential balloon inflation at pressures up to 12 atmospheres successfully expanding the stenosis to a maximum diameter of 4.9 mm and restoring improved venous flow. For practitioners, this work establishes jugular stenosis as a distinct differential diagnosis for unilateral jugular dilatation independent of iatrogenic causes, and demonstrates that minimally invasive angioplasty offers a viable therapeutic option where conventional management has proven insufficient.
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Practical Takeaways
- •Include jugular vein stenosis in your differential diagnosis for unilateral jugular vein dilatation in horses, even without a history of intravenous catheterization
- •Ultrasonographic examination can reliably identify stenotic lesions and measure vessel diameter to guide treatment decisions
- •Percutaneous transluminal angioplasty is a feasible minimally invasive option to restore jugular blood flow in affected horses, potentially eliminating exercise-related signs like headshaking
Key Findings
- •Five horses presented with unilateral jugular vein dilatation caused by stenosis located 5-10 cm cranial to the thoracic inlet with internal diameter reduced to 1-3.1 mm
- •Stenosis developed spontaneously in four horses without prior intravenous treatment, and in one horse following removal of an indwelling catheter
- •Percutaneous transluminal angioplasty successfully dilated stenotic segments from maximum 3.1 mm to 4.9 mm using pressures up to 12 atm with improved blood flow
- •Two of five horses exhibited headshaking during exercise as a clinical manifestation of the venous stenosis