Triple-phased mesenteric CT angiography using a test bolus technique for evaluation of the mesenteric vasculature and small intestinal wall contrast enhancement in dogs

Computed tomography angiography is widely used for the assessment of various mesenteric vascular and bowel diseases in humans. However, there are only few studies that describe CT angiography application to mesenteric vessels in dogs. In this prospective, experimental, exploratory study, the mesenteric vasculature and enhancement pattern of the intestinal wall were evaluated on triple-phase CT angiography, and improvement of the visibility of vasculature was assessed on multiplanar reformation, maximum intensity projection, and volume rendering technique. After test bolus scanning at the level of the cranial mesenteric artery arising from the aorta, mesenteric CT angiography was performed in 10 healthy, male, Beagle dogs. Scan delay was set based on time-to-attenuation curves, drawn by placing the regions of interest over the aorta, intestinal wall, and cranial mesenteric vein. Visualization and enhancement of mesenteric arteries and veins were evaluated with multiplanar reformation, maximum intensity projection, and volume rendering techniques. The degree of intestinal wall enhancement was assessed on the transverse images in precontrast, arterial, intestinal, and venous phases. Pure arterial images were obtained in the arterial phase. Venous phase images allowed good portal vascular mapping. All CT angiography images were of high quality, allowing for excellent visualization of the anatomy of mesenteric vasculature including the small branches, particularly on maximum intensity projection and volume rendering technique. Distinct contrast enhancement of the intestinal wall was observed in both intestinal and venous phases. Findings indicated that this technique is feasible for the evaluation of mesenteric circulation in dogs.

Transcatheter embolization of systemic-to-pulmonary artery fistulas in a dog using embolization coils and silk suture

A 4-month-old intact female Cavalier King Charles spaniel presented for evaluation of a left, basilar continuous murmur. Transthoracic echocardiography suggested anomalous vessels around the main pulmonary artery, and computed tomography angiography revealed two systemic-to-pulmonary artery fistulas. Transcatheter embolization of these fistulas was achieved with a combination of embolization coils and silk suture threads delivered through a microcatheter.

Evaluation of a pre-tied ligature loop for canine total lung lobectomy

OBJECTIVE

To determine the ability of a pre-tied ligature loop (PLL) to create a seal against physiological airway pressures after total lung lobectomy and report outcomes in dogs requiring lung lobectomy.

STUDY DESIGN

Ex vivo experimental randomized study and clinical case study.

SAMPLE POPULATION

Thirty cadaveric canine lung lobes and 5 client-owned dogs.

METHODS

Thirty canine lung lobes from dogs weighing 22.5-35 kg were randomized to lobectomy with stapler, PLL, or suture ligation. After lobectomy, each bronchial stump was submerged in water, and the mainstem airway pressure was increased to 80 mm Hg. Leakage was compared between techniques. The PLL was subsequently used in 5 dogs (17-25 kg) with neoplastic disease requiring total lung lobectomy.

RESULTS

Two stapled and 4 sutured bronchial stumps leaked at supraphysiological pressures >15 mm Hg. One stapled bronchial stump failed at a physiological airway pressure (5 mm Hg). None of the PLL lobectomies leaked. The incidence of bronchial stump failures did not differ among techniques (P = .15). Lung lobectomy was performed successfully with the PLL in 5 clinical cases with no intraoperative or postoperative complications; median follow-up time was 6 months.

CONCLUSION

Bronchial ligation with the PLL reliably resisted physiological airway pressures and performed comparably to current standard techniques in cadavers. The PLL provided an adequate air and vascular seal in 5 clinical cases undergoing total lung lobectomy.

CLINICAL RELEVANCE

Pre-tied ligature loops provide an alternative method for total lung lobectomy in dogs.