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. 2022 Mar;36(2):441-450.
doi: 10.1111/jvim.16359. Epub 2022 Feb 7.

Stenting of the caudal aorta and aortic trifurcation for the treatment of thrombosis in 7 dogs

Kelly A Gavin  1 , Chick Weisse  2 , Allyson C Berent  2
Affiliations

Stenting of the caudal aorta and aortic trifurcation for the treatment of thrombosis in 7 dogs

Kelly A Gavin et al. J Vet Intern Med. 2022 Mar.

Abstract

Background: Aortic and aortoiliac thrombosis in dogs causes disease and death.

Objective: To describe the procedure and outcomes for stenting the caudal aorta and aortoiliac trifurcation.

Animals: Seven client-owned dogs that underwent aortic/aortoiliac stenting for treatment of thrombosis.

Methods: Retrospective multi-center investigation. Medical records were reviewed for dogs that underwent stenting of the aorta or aortoiliac trifurcation between 2008 and 2020. Information collected included history, signalment, clinicopathologic data, diagnostic imaging, procedure reports, and outcomes.

Results: Seven dogs with an occlusive thrombus located at or near the aortic trifurcation were included. Four of 7 dogs were non-ambulatory. Hind limbs were paretic in 5 dogs, paralyzed in 1 dog, and claudication alone was noted in 1 dog. Five of the 7 dogs had protein-losing nephropathy (PLN). Of 5 dogs with PLN, 1 had protein-losing enteropathy (PLE) and controlled hypothyroidism and 1 had caudal aortic chondrosarcoma. Two dogs had no identified underlying disease. Angiography was performed before catheter directed thrombolysis and stent placement. No deaths occurred during the procedure. Postoperative complications included pain (4/7), bruising and edema (3/7), bruising only (1/7), and edema only (1/7). Median survival time (MST) of the 7 dogs was 264 days (range, 1-1053 days). Five of 7 dogs were ambulatory within 2 days of stenting and survived to discharge with a MST of 425 days (range, 208-1053 days).

Conclusions and clinical importance: Stenting of the aorta and aortoiliac trifurcation can provide an apparently safe and effective treatment with rapid return to ambulation for some dogs with aortic thrombosis.

Keywords: anticoagulation; aortoiliac; hypercoagulability; leriche syndrome; rivaroxaban; stents; thrombolysis.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Digital subtraction angiogram (DSA) images of 4 dogs, a 13‐year‐old female spayed Soft‐Coated Wheaten Terrier (A,B), a 12‐year‐old male neutered Greyhound (C,D), a 7‐year‐old female spayed Labrador Retriever (E,F), and an 8‐year‐old male neutered Golden Retriever (G,H) before (A,C,E,G) and after (B,D,F,H) stent placement. (A) Terminal aortic (Ao) DSA through marker pigtail catheter demonstrating filling defect (upper arrow) cranial to the aortic bifurcation extending distally into the external iliac arteries (ExtIl) in a 13‐year‐old female spayed Soft‐Coated Wheaten Terrier. Both internal iliac artery origins are occluded with distal reconstitution of the right internal iliac artery (RtIntIl) visible (lower arrow). (B) Repeat DSA image after placement of 2 “kissing” stents (arrowheads) revealing improved flow through the stents with persistent filling defects at the distal external iliac arteries but overall improved flow. (C) Terminal aortic (Ao) DSA through marker catheter demonstrating left external iliac artery (LtExtIl) and bilateral internal iliac artery origin occlusions secondary to a large distal aortic/LtExtIl thrombus (arrows) with a moderate amount of collateral circulation in a 12‐year‐old male neutered Greyhound. A lesser degree of right external iliac artery (RtExtIl) occlusion is also appreciated. (D) Repeat DSA image after placement of 2 “kissing” stents (arrowheads) revealing improved flow through the stents with restoration of LtExtIl blood flow and improvement of RtExtIl patency after stent placement (arrowheads). The comparative improved overall opacification demonstrates the improved perfusion to the hind limbs. (E) Dual aortic (Ao) and terminal aortic DSAs through catheters demonstrating a thrombus limited to the aorta (Ao) resulting in complete aortic occlusion (arrows) caudal to the renal arteries obstructing blood flow to the terminal aorta in a 7‐year‐old female spayed Labrador Retriever. The renal artery circulation appears normal. Prominent collateral circulation is observed helping to reconstitute the terminal aorta as well. (F) Repeat DSA image after placement of 2 side‐by‐side aortic stents (arrowheads) revealing restoration of blood flow to the caudal Ao. (G) Terminal aortic (Ao) DSA through marker pigtail catheter demonstrating filling defect (arrow) cranial to the aortic trifurcation extending distally into the external iliac (ExtIl) arteries in an 8‐year‐old male neutered Golden Retriever. Both internal iliac artery origins are occluded. (H) Repeat DSA image after placement of 2 “kissing” stents (arrowheads) revealing improved flow through the stents with restoration of left external iliac artery (LtExtIl) and right external iliac artery (RtExtIl) blood flow
FIGURE 2
FIGURE 2
Serial DSA images of a 6‐year‐old male neutered mix‐breed dog before stent placement (A), after placement of 2 initial “kissing” stents (B) and after placement of a third stent extending down the left external iliac (LtExtIl) artery (C). (A) Terminal aortic (Ao) DSA through marker pigtail catheter demonstrating filling defect (arrow) cranial to the aortic bifurcation with diminished internal and right external iliac artery perfusion. Thrombus in the caudal aorta (Ao) and right external iliac artery (RtExtIl; upper arrow) with collateralization is noted. There is moderate flow through the left internal iliac artery (LtIntIl). Distal thrombi were appreciated in the LtExtIl (lower arrow). The aortoiliac thrombus compromises blood flow through the right external iliac artery with no visible flow through the right internal iliac artery. (B) Repeat DSA image after placement of 2 “kissing” stents (arrowheads) revealing improved flow through the stents with persistent filling defects at the distal external iliac arteries but overall improved but still diminished flow through both external iliac arteries. A filling defect (arrows) is appreciated distal to the stent (arrowheads) placed in the LtExtIl. (C) Repeat DSA image after placement of a third stent (broad arrowheads) distal to the first in the LtExtIl resulting in improved blood flow and opacification of the left hind limb
See this image and copyright information in PMC

References

    1. Dunn M, Scansen BA. Interventional radiology Management of Vascular Obstruction. Vet Clin North Am Small Anim Pract. 2018;48(5):819‐841. - PubMed
    1. Lake‐Bakaar GA, Johnson EG, Griffiths LG. Aortic thrombosis in dogs: 31 cases (2000‐2010). J Am Vet Med Assoc. 2012;241(7):910‐915. - PubMed
    1. Winter RL, Sedacca CD, Adams A, et al. Aortic thrombosis in dogs: presentation, therapy, and outcome in 26 cases. J Vet Cardiol. 2012;14(2):333‐386. - PubMed
    1. Van Winkle TJ, Liu SM, Hackner SG. Clinical and pathological features of aortic thromboembolism in 36 dogs. J Vet Emerg Crit Care. 1993;3:13‐21.
    1. Ruehl M, Lynch AM, O'Toole TE, et al. Outcome and treatments of dogs with aortic thrombosis: 100 cases (1997–2014). J Vet Intern Med. 2020;34(5):1759‐1767. - PMC - PubMed