Tapio Heidi, Argüelles David, Gracia-Calvo Luis A, Raekallio Marja
Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
Vet Surg. 2017 Jan;46(1):52-58. doi: 10.1111/vsu.12585. Epub 2016 Nov 28.
To describe a modified technique for permanent translocation of the common carotid artery (CCA) to a subcutaneous position in standing horses.
Experimental study.
Healthy adult Standardbred and Warmblood horses (n = 8).
Surgery was performed with the horses standing under sedation and with local anesthesia. A combination of previously described techniques was used modifying the approach and closure of the incision. The right CCA was approached through a linear skin incision dorsal and parallel to the jugular vein and through the brachiocephalicus and omohyoideus muscles. The artery was dissected free of its sheath and elevated to the skin incision with Penrose drains. The brachiocephalicus muscle was sutured in two layers underneath the artery leaving it in a subcutaneous position. The horses were allowed to heal for 3 weeks prior to catheterization of the artery.
The transposed CCA was successfully used for repeated catheterization in six of eight horses for a period of 10 weeks. None of the horses had intraoperative complications. Two horses developed mild peri-incisional edema that resolved spontaneously. Right-sided laryngeal hemiplegia was observed endoscopically in two horses postoperatively. Two horses developed complications (surgical site infection and excessive periarterial fibrosis) that compromised the patency of the CCA and precluded catheterization.
Permanent translocation of the CCA in standing horses was successful in six out of eight horses. Upper airway endoscopy postoperatively may be warranted as laryngeal hemiplegia may ensue.
描述一种改良技术,用于将成年站立马匹的颈总动脉(CCA)永久性移位至皮下位置。
实验研究。
健康成年标准赛马和温血马(n = 8)。
在镇静和局部麻醉下对马匹进行手术。采用先前描述的技术组合,对切口入路和缝合进行改良。通过在颈静脉背侧且与之平行的直线皮肤切口,穿过臂头肌和肩胛舌骨肌来暴露右侧CCA。将动脉从其鞘膜中游离出来,并用橡皮引流管将其提升至皮肤切口处。将臂头肌在动脉下方分两层缝合,使动脉处于皮下位置。在对动脉进行插管前,让马匹愈合3周。
8匹马中有6匹的移位CCA成功用于重复插管,持续10周。所有马匹均未出现术中并发症。2匹马出现轻度切口周围水肿,可自行消退。术后通过内镜观察到2匹马出现右侧喉偏瘫。2匹马出现并发症(手术部位感染和动脉周围过度纤维化),影响了CCA的通畅性,无法进行插管。
8匹马中有6匹成年站立马匹的CCA永久性移位手术成功。术后可能需要进行上呼吸道内镜检查,因为可能会出现喉偏瘫。