Femoral artery thrombectomy

Proximal saddle emboli at the aortic bifurcation can be removed through the femoral artery using a Fogarty Thrombectomy catheter. By passing through the embolus, and by dilating the metal cage the clot can be catched and withdrawn, restoring the blood flow to the lower extremity.

The chronic arterial occlusive disease of the aorta and its caudal arteries, also referred to as aortic-iliac thrombosis (TAI), is characterized by a reproducible predictable exercise induced hind limb lameness that disappears with a resting period of 5–10 min. Horses that are forced to train ‘through the pain’ show a more severe lameness and may require significantly more time for the clinical signs to resolve. The worse the signs, the longer recovery takes. Affected horses could be without signs or show only vague performance complaints; however, the clinical signs can also be very severe and acute colic-like after training. The severity of clinical signs is related to the degree of vascular occlusion, the presence of collateral circulation and the speed of onset of the occlusion. If the external iliac artery and/or femoral artery are occluded for more than 60% exercise-induced reproducible lameness that subsides with rest can occur. The signs are caused by ischaemia in the hind limb tissues as a result of insufficient perfusion due to vascular occlusion. The disease is a progressive vascular disease and has a gradual onset and thus might not be noticed initially. In all cases described for TAI the thrombus has had its origin in the aorta and slowly grew in the direction of the bifurcation. It might be possible for a thrombus to start cranial to the mesenteric arteries and occlude these arteries resulting in ischaemia of the intestine. While extending caudally, the external and internal iliac arteries can be partly or totally occluded. Is the femoral artery involved the symptoms as described can occur, is only the internal iliac artery involved the horse might show infertility.

The prevalence of the disease in horses is unknown because the majority of patients is asymptomatic, show vague symptoms or remains undiagnosed. It is likely that the true prevalence in horses is higher than suspected, due to the unawareness of the practitioner. [...]