Comparison of Fogarty and Vollmar thrombectomy for chronic jugular thrombosis in horses

Abstract

Abstract Background Chronic jugular vein thrombosis may result in persistent venous obstruction and impaired head drainage. Although surgical thrombectomy is performed in selected cases, experimental comparisons between mechanical techniques for chronic thrombus removal in horses are lacking. Objectives To compare Fogarty catheter thrombectomy alone with a combined Vollmar ring–Fogarty technique for restoration and maintenance of luminal patency in experimentally induced chronic jugular thrombosis. Study Design Randomised in vivo study. Methods Chronic right jugular thrombosis was induced in 10 healthy adult horses. After confirmation of thrombus chronicity (D13), horses underwent thrombectomy using the Fogarty catheter (FG; n = 5) or a combined Vollmar ring–Fogarty technique (VFG; n = 5). Clinical, ultrasonographic, and venographic evaluations were performed until D27 and analysed in two phases: thrombus induction/chronicity (D0–D13; n = 10) and post‐thrombectomy follow‐up (D13–D27; n = 5 per group). Quantitative data are presented as mean ± SD. Results Both techniques restored luminal patency intraoperatively. The Vollmar–Fogarty approach removed a greater thrombus mass (32 ± 6 g vs. 8 ± 2 g), yet VFG horses developed variable early postoperative re‐occlusion with persistent partial obstruction at 6 h. In contrast, 3/5 FG horses demonstrated partial luminal patency at D14. At D27, sustained functional patency was observed in 3/5 FG and 1/5 VFG horses; remaining cases showed partial recanalisation with serpiginous channels. Thrombus length progressively decreased in both groups, and no major intraoperative complications occurred. Main Limitations Small sample size and use of an experimental model in healthy horses may limit generalisability. Imaging assessments were performed by a single investigator, although blinded analysis was undertaken. Conclusions Both techniques re‐established venous flow in chronic jugular thrombosis; however, Fogarty thrombectomy achieved more sustained patency at 27 days despite removing smaller thrombus fragments. Further clinical studies are warranted.