Manual graphic roadmap for transarterial coil embolization of guttural pouch arteries in horses: A technical note.

MGR-assisted TACE reduces contrast use and improves anatomical guidance for equine guttural pouch hemorrhage.

This technical note presents a practical manual graphic roadmap (MGR) technique to enhance fluoroscopic guidance during transarterial coil embolization (TACE) for guttural pouch arterial hemorrhage in horses. The MGR method involves securing transparent foil to the fluoroscopy monitor and tracing vascular anatomy with a waterproof marker following initial angiography. This traced roadmap then serves as a continuous reference for catheter navigation and coil placement throughout the procedure. The technique was implemented in all TACE procedures at the Equine Clinic of the Free University of Berlin between 2012-2024, performed under general anesthesia. By providing consistent anatomical orientation, the MGR reduces the need for repeated contrast injections, requiring additional contrast only to verify final vessel occlusion. This approach offers a cost-effective alternative for institutions lacking advanced fluoroscopic roadmap technology, potentially decreasing contrast usage and radiation exposure. The authors acknowledge the need for further research to objectively evaluate procedural parameters and efficiency under standardized conditions.

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