Partial and autologous patch venoplasty of the jugular vein in a horse

Introduction Experience with vascular surgery is limited In horses and autologous vein grafts have only been used for thrombophlebitis treatment. In human surgery several venoplasty techniques are commonly used. The aim was to describe treatment of a jugular vein pseudo-aneurysm using an autologous saphenous vein patch technique to create an isodiametric lumen and minimize thrombus formation. Case Description A 3-year-old female pony was presented with an intermittent local swelling of the left jugular vein after a former thrombo-phlebitis and resulting exercise intolerance. Ultrasonographic examination revealed a large pseudo-aneurysm. Treatment consisted of a partial aneurysmectomy preserving part of the vein wall. The saphenous vein was harvested and cut longitudinally to increase the surface of the patch, which was then sutured to the remaining jugular vein wall. Anticoagulants, antimicrobial and anti-inflammatory drugs were administered post-operatively. Follow-up ultrasounds showed narrowing (0,7cm) of the caudal part of the graft. Results At 2 and 8 months post-operatively no external deformation of the jugular vein was visible. Ultrasonography revealed patent blood flow with limited lumen narrowing (1.5cm) and a homogeneous vein wall, except for some remaining sutures. Discussion The patch venoplasty proved a viable surgical technique for jugular vein reconstruction resulting in an isodiametric lumen, no thrombus formation and a good cosmetic outcome. Additional research is needed to evaluate other venoplasty techniques for treating vascular pathology in horses.