Bacon Miller C, Wilson D A, Martin D D, Pace L W, Constantinescu G M
Department of Veterinary Medicine and Surgery, University of Missouri, College of Veterinary Medicine, Columbia, MO 65211, USA.
Vet Surg. 1998 Sep-Oct;27(5):450-3. doi: 10.1111/j.1532-950x.1998.tb00155.x.
A 3-year-old Quarter Horse gelding was treated for left guttural pouch mycosis by ligation and balloon catheterization of the left internal carotid artery. Catheter advancement was shorter (10 cm) than the normally reported distance (13-15 cm), but was observed endoscopically during placement as it coursed within the internal carotid artery through the guttural pouch. The horse developed a persistently abnormal respiratory pattern after catheter placement, failed to gain consciousness, developed pulmonary edema, and died 5.5 hours postoperatively. Postmortem examination revealed an aberrant left internal carotid arterial course with location of the embolectomy catheter at the junction of the basilar and caudal cerebellar arteries. Brainstem neuronal necrosis and alveolar and interstitial pulmonary edema were identified on histological examination. Angiography may be used to identify aberrant branching patterns. Failure to identify and occlude aberrant branches may result in fatal epistaxis and Brainstem lesions.
一匹3岁的夸特马种公马因左侧咽囊真菌病接受了左侧颈内动脉结扎和球囊导管插入术治疗。导管推进的距离（10厘米）比通常报道的距离（13 - 15厘米）短，但在放置过程中通过内窥镜观察到它在颈内动脉内穿过咽囊。这匹马在导管放置后出现持续异常的呼吸模式，未能苏醒，发展为肺水肿，并在术后5.5小时死亡。尸检发现左侧颈内动脉走行异常，取栓导管位于基底动脉和小脑后动脉交界处。组织学检查发现脑干神经元坏死以及肺泡和间质肺水肿。血管造影可用于识别异常分支模式。未能识别和闭塞异常分支可能导致致命性鼻出血和脑干病变。
