Time course of reendothelialization of stents in a normal coronary swine model: characterization and quantification

Late thrombosis of coronary drug-eluting stents is an infrequent but serious complication of percutaneous transluminal coronary angioplasty. The best predictor of this event is the lack of endothelialization of stent struts. The objective of this study is to characterize and quantify the time course of endothelialization of different stents implanted in nonatherosclerotic swine coronary arteries. Thirty-three Carbofilm-coated stents were implanted percutaneously in 11 anesthetized domestic, crossbred pigs (weight 25 ± 3 kg, 2 months old). Each animal received 1 stainless steel stent (SS), 1 cobalt-chromium stent (CCS), and 1 tacrolimus-eluting stent (TES) in each coronary artery. Follow-up periods were 1 day (n = 9 stents), 3 days (n = 9 stents), and 7 days (n = 15 stents). Longitudinal sections of the stented vessels were examined using scanning electron microscopy. At 1 day, there was scarce, patchy endothelialization with areas of fibrin; the endothelialization rate was similar for all the stents (SS, 29% ± 23%; CCS, 29% ± 24%; TES, 31% ± 25%; P = .9). At 3 days, there were more endothelial cells but with immature features and giant cells over fibrin; the endothelialization was greater in SS and CCS than in TES (SS, 79% ± 14%; CCS, 81% ± 17%; TES, 46% ± 9%; P = .007). At 7 days, arteries showed better endothelialization with few giant cells; the endothelialization was greater in SS and CCS than in TES (SS, 95% ± 4%; CCS, 98% ± 4%; TES, 79% ± 9%; P = .01). In conclusion, the described model is useful for the analysis of endothelialization of coronary stents and facilitates measurement of its rate of formation and characterization of the involved cell types.     

The Safety and efficacy of a new self-expandable intratracheal nitinol stent for the tracheal collapse in dogs

To evaluate the potential utility of a self-expandable intratracheal nitinol stent with flared ends for the treatment of tracheal collapse in dogs, endotracheal stenting therapy was performed under fluoroscopic guidance in four dogs with severe tracheal collapse. During the 4 to 7 month follow-up, after stent implantation, clinical signs, including dyspnea and respiratory distress, dramatically improved in all dogs. The radiographs showed that the implanted stents improved the tracheal collapse, and there were no side effects such as collapse, shortening or migration of the stents. In conclusion, the self-expandable intratracheal nitinol stents provided adequate stability to the trachea and were effective for attenuating the clinical signs associated with severe tracheal collapse.     

Stent angioplasty for treatment of canine valvular pulmonic stenosis

Four dogs presented for evaluation and treatment of severe pulmonic valve stenosis and underwent stenting of the pulmonic valve annulus using bare-metal balloon-expandable stents. All dogs survived the procedure with immediate reduction of the transpulmonary valve pressure gradient and increase in activity levels. One dog had a stent fracture and migration 1 month after the intervention. This dog underwent a second procedure, in which multiple stents were used to alleviate the obstruction. The stents that were placed at the level of the right ventricular outflow tract fractured within 1 month of the procedure, and the patient died when a third (surgical) approach was attempted. The other three dogs remain alive 54, 42, and 29 months after the procedure. Stent angioplasty may be a viable option for dogs with valvular pulmonic stenosis in which routine balloon valvuloplasty does not provide a successful outcome. Aggressive attempts to diminish RVOT dynamic obstruction with high-dose beta blockade and avoiding deployment of the stent within the RVOT are recommended to prevent stent fracture and migration.     

Comparison of bare metal stent and paclitaxel-eluting stent using a novel rat aorta stent model

The purpose of our study was to create a novel rat aorta stent implantation model. Stainless steel bare metal stents (BMS) or paclitaxel-eluting stents (PES) were implanted in male Sprague-Dawley rats (BW 400 ± 20 g). Two and four weeks after stent implantation, the aorta were collected, fixed with 2% glutaraldehyde, and cut into two segments. One segment was used for scanning electron microscopy analysis to evaluate re-endothelialization, and the other segment was used to calculate the neointimal area. At 2 weeks after stenting, the appearance of neointimal hyperplasia was less in the PES group than in the BMS group. At 4 weeks after stenting, no significant difference in neointimal hyperplasia was observed between two groups. On the other hand, the PES group showed more thrombus formation and less re-endothelialization compared to the BMS group. This study demonstrated the ability of a novel rat model of aorta stenting via a common carotid artery to measure the efficacy and safety of commercially available drug-eluting stents.     

Surgical outcomes in dogs with tracheal collapse treated with a novel cross-and-hook braided endoluminal stent

BackgroundStenting is an effective treatment option for tracheal collapse in dogs. Cross-braided tracheal stents are currently the norm in veterinary medicine, but cross-and-hook braided stents have recently been adopted in human medicine. We examined whether stents manufactured using this novel braiding technique provided additional advantages for the treatment of tracheal collapse in dogs.ObjectivesTo evaluate the outcomes of cross-and-hook braided stent implantation in the treatment of tracheal collapse in dogs.MethodsThe medical records of 22 client-owned dogs that underwent luminal placement of cross-and-hook braided Fauna Stents for the treatment of tracheal collapse between January 2018 and July 2021 were examined and data on canine signalment, clinical signs, diagnostic test results, surgical outcomes, and postoperative complications were retrieved and analyzed statistically.ResultsTwenty-six stents were surgically implanted, with 20 dogs (90.9%) receiving one stent and the remaining two (9.1%) receiving two or more stents. All dogs survived the procedure. The median survival time at a median follow-up of 990 days was 879 days. At the final follow-up examination, loss or mild improvement of cough was observed in all dogs.ConclusionsCompared with conventional lumen stents, the cross-and-hook braided Fauna Stent offered a higher survival rate and improved clinical symptoms in all patients. The results of this study suggest that the Fauna Stent may be a promising treatment option for dogs with tracheal collapse.     

Total Hip Prosthesis for Revision of Unsuccessful Excision Arthroplasty

Two types of total hip prostheses were implanted in three dogs that had been previously treated by excision arthroplasty, two for degenerative joint disease secondary to hip dysplasia and one for removal of a fractured femoral neck. Complications occurred in one case when the femoral shaft was split during the reaming process for implantation of the prosthesis and at three weeks after surgery when an oblique fracture of the distal femur occurred. Both complications were treated successfully. The time since surgery varied between eight and 18 months. All three dogs had excellent functional results evidenced by increased joint mobility and freedom from pain.     

Fracture of an endoluminal nitinol stent used in the treatment of tracheal collapse in a dog

A 5-year-old castrated male Pomeranian was evaluated because of severe dyspnea and coughing, and a diagnosis of complete, static collapse of the trachea at the thoracic inlet was made. After failure to improve with medical management alone, an endoluminal tracheal stent was placed, which resulted in resolution of signs. Ten weeks after stent placement, the dog underwent tracheal resection and anastomosis because the stent had fractured at the level of the thoracic inlet. One year after surgery, the dog was doing well and required treatment with hydrocodone infrequently. Compared with other surgical treatment options, placement of an endoluminal tracheal stent is a relatively noninvasive intervention that can provide effective relief from the clinical signs associated with tracheal collapse in dogs. Implantation of endoluminal tracheal stents may be associated with complications; therefore, the procedure may best be regarded as a salvage procedure for dogs with end-stage disease that are refractory to appropriate medical management, have extensive collapse of the intrathoracic portion of the trachea, or are poor candidates for surgery.     

Placement of intraluminal stents for treating tracheal collapse in dogs

Tracheal collapse is a progressive disease particularly of small breed dogs. In the terminal stage, when dyspnea becomes the dominating sign and is no longer manageable with medical treatment, a surgical procedure is necessary. With increasing frequency intraluminal tracheal stents are implanted minimal-invasively. In individual animals this is a lifesaving procedure, leading to immediate elimination of dyspnea. In most dogs cough for some time has to be anticipated as the stent acts as a foreign body, but severe complications like excessive formation of granulation tissue, stent migration or stent fracture are rare. Stents represent an attractive treatment modality for tracheal collapse in dogs with dyspnea.     

Extraction of fractured cheek teeth under oral endoscopic guidance in standing horses

Objective: To evaluate a technique for oral extraction of fractured cheek teeth (CT) under oral endoscopic guidance. Study Design: Case series. Animals: Horses (n=30) with fractured CT. Methods: Medical records (April 2007–August 2010) of horses that had standing oral extraction of fractured CT under endoscopic guidance were reviewed. Results: Thirty horses (median age, 11.5 years; range, 5–23 years) had 31 fractured CT (21 maxillary, 10 mandibular) removed. Midline sagittal fractures of maxillary teeth (n=13; 42%) were the most common type, followed by buccal or palatal (10; 32%), and transverse or multiple (5; 16%) fractures. Extraction under endoscopic guidance was successful for 27 (87%) teeth. Median age of the surgical failure group was 7 years (range, 5–8 years), significantly lower than that of the surgical success group (P=.0135, Mann–Whitney U‐test). Conclusions: Endoscopic viewing facilitates instrument use and removal of fractured CT in standing horses.     

Evaluation of palliative stenting for management of malignant urethral obstructions in dogs

OBJECTIVE: To evaluate use of balloon-expandable and self-expanding metallic stents in management of malignant urethral obstructions in dogs. DESIGN: Original study. ANIMALS: 12 dogs with malignant urethral obstructions. PROCEDURES: The extent and location of urethral obstructions and the diameter of adjacent unaffected luminal segments were determined by use of fluoroscopically guided wires and measuring catheters. Stents were chosen to extend approximately 1 cm proximal and distal to the obstruction. Stent diameters were chosen to be approximately 10% greater than the diameter of healthy portions of the urethra to prevent displacement. Stents were placed in the urethra under fluoroscopic guidance to restore luminal patency. RESULTS: 3 dogs received balloon-expandable metallic stents, and 9 dogs received self-expanding metallic stents. The placement procedures were rapid, safe, and effective at restoring luminal patency and were not associated with major complications. Complications included recurrent urethral obstruction secondary to blood clot formation and urethral edema in 1 dog and stent dislodgement into the urinary bladder in 1 dog. All dogs were able to urinate immediately after the procedure. Nine dogs (3/4 females and 6/8 males) were continent or mildly incontinent after stent placement. Of the remaining 3 dogs, 2 developed severe incontinence and 1 had an atonic bladder. Seven dogs were considered to have good to excellent outcome, 3 had fair outcome, and 2 had poor outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Transurethral placement of metallic stents was a safe and effective palliative treatment option for dogs with malignant urethral obstructions.     

Coracoid fractures in wild birds: repair and outcomes

OBJECTIVE: To describe the surgical repair of the fractured avian coracoid and compare release rates back to the wild for birds treated surgically with those treated conservatively. DESIGN: Medical records of 17 birds presented to Healesville Sanctuary with fractured coracoids were examined retrospectively. Nine birds were treated conservatively and eight birds were treated surgically. Release rates back to the wild were compared between the two groups. RESULTS: Of the nine birds treated conservatively two were released back to the wild. Of the eight birds treated surgically six were released back to the wild. CONCLUSIONS: In this study greater success at returning birds with fractured coracoids to the wild was achieved with surgical repair than conservative treatment. Surgical repair is recommended for birds intended to be released back into the wild.     

Conservative treatment of an incomplete longbone fracture of a hindlimb of four horses

Four horses with an incomplete fracture of a hindlimb longbone were examined. In two, the tibia had been fractured by external trauma. In the other two horses proximal metatarsal 3 had fractured during normal activity. The diagnoses were made radiographically and the horses were treated conservatively by box rest. The fractures healed satisfactorily and the horses became sound.     

Quantitative analysis of scintigraphic findings in tibial stress fractures in Thoroughbred racehorses

OBJECTIVE: To develop a quantitative method of interpreting tibial scintigrams of Thoroughbred racehorses with tibial stress fractures that may facilitate diagnosis of fractures and to provide prognostic information regarding future performance of affected horses. ANIMALS: 35 Thoroughbred racehorses. PROCEDURES: Static bone-phase scintigrams of tibial stress fractures were quantitatively analyzed by use of ratios of the mean radionuclide counts per pixel in a region of interest (ROI) drawn around the area of increased uptake of radiopharmaceutical to mean counts per pixel in a second ROI drawn around an apparently normal area of the tibial diaphysis. In horses with unilateral fractures, ratios for the contralateral tibia were determined by use of 2 ROIs drawn at the same positions as the ROIs in the fractured tibia. Ratios were compared between fractured versus apparently normal tibias, between horses that returned to racing versus those that did not, and among horses with various grades of lameness. The association between ratios for fractured tibias and intervals between diagnosis and return to racing was also assessed. RESULTS: Mean ratio of ROIs in apparently normal tibias was 1.35 (95% confidence interval [CI], 1.21 to 1.50); that in tibias with stress fractures was 3.55 (95% CI, 2.50 to 4.60). These ratios were significantly different. None of the associations between ratios for fractured tibias and grades of lameness or performance outcomes were significant. CONCLUSIONS AND CLINICAL RELEVANCE: Tibial stress fracture scintigrams can be quantitatively analyzed. A prospective study with a controlled rehabilitation period is necessary to evaluate the possible applications of this method.     

Nasolacrimal obstruction caused by root abscess of the upper canine in a cat

A 10‐year‐old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.     

Dowel pinning for feline metacarpal and metatarsal fractures.

The goal of this retrospective study was to describe dowel pinning, and to compare the results of osteosynthesis and external coaptation of metacarpal and metatarsal fractures in cats. Evaluation of the medical records of 351 cats yielded 63 cats treated with dowel pinning, 35 cats treated with external coaptation and 14 cats treated with both methods within the same limb. All of the cats had been re-evaluated at an average of 2.8 years (six months - 15 years) postoperatively. Dowel pinning was superior to external coaptation when all fractured bones of a limb could be pinned. When internal fixation of multiple fractures was not feasible in all fractured bones due to comminution or fragments that were too short to pin, the outcome was not significantly different from cases treated with external coaptation alone. Malunion was seen in 16% of fractured bones in cats treated with external coaptation and occurred secondary to implant bending in 3% of fractured bones treated with dowel pinning. The latter refers to one operated cat, which had four metacarpal fractures in the same limb. Radiographs taken at re-evaluation showed implant migration within the medullary canal in two cats, although neither showed any signs of non-union or lameness. Non-union was seen in one operated cat, in which the fracture (MC IV) could not be completely reduced with a K-wire. Osteomyelitis did not occur. Dowel pinning is an easy, inexpensive and effective technique for repair of metacarpal and metatarsal fractures in cats.     

Ultrastructure of Anaplasma marginale after freeze-fracture.

Stained thin sections and freeze-fractured replicas of Anaplasma marginale-infected bovine erythrocytes were examined by electron microscopy. Freeze-fracture replication not only verified basic Anaplasma ultrastructure, but also allowed visualization of structures not previously reported. Because of the partial 3-dimensional views obtained with freeze-fracture replication, a new structure that appears as a protruding tip was discernible. Also, the surface of Anaplasma's limiting membrane was less granular than the fractured surface of host erythrocyte. A corrugated surface with a periodicity of 10.5 nm was seen when the limiting membrane was fractured.     

Use of a retained urethral catheter in three dogs with prostatic neoplasia.

Percutaneous nephrostomy catheters modified by cutting off the tubing connectors were implanted in three dogs with prostatic neoplasia to relieve or prevent stranguria. One catheter was implanted with a guide wire through a perineal urethrotomy, and two catheters were implanted via celiotomy and cystotomy. Morbidity and complications were minimal. Inflammation of the abdominal incision was present from day 4 to day 8 in the dogs with celiotomy. Urinary incontinence was continuous in one dog and intermittent in two dogs. Hematuria occurred in two dogs. The retained urethral catheter was a suitable palliative treatment for urethral obstruction in three dogs with prostatic neoplasia.     

Surgical extraction of a fractured, non-vital deciduous tooth in a tiger

A 10-month-old, female/intact tiger (Panthra tigris) was presented for a fractured deciduous mandibular right canine tooth, mandibular swelling, and a cutaneous draining tract ventral to the apex of the fractured tooth. The tooth had chronic pulpal exposure and was considered non-vital with periapical osteomyelitis. This case report describes treatment to optimize normal development and eruption of the permanent mandibular right canine tooth.     

Induction of Ovulation of Ovulatory Size Non‐Ovulatory Follicles and Initiation of Ovarian Cyclicity in Summer Anoestrous Buffalo Heifers (Bubalus bubalis) Using Melatonin Implants

This study was conducted on summer anoestrous buffalo heifers to monitor the efficacy of melatonin for induction of ovulation and ovarian cyclicity. During pre‐treatment period of 24 days, the ovarian dynamics of five cycling and 10 summer anoestrous heifers was monitored on each alternate day using a transrectal ultrasound scanner. Thereafter, during treatment period, these 10 anoestrous heifers along with additional seven anoestrous heifers were randomly allocated into non‐implanted (n = 5) and implanted (n = 12, one melatonin implant/50 kg, 18 mg melatonin/implant) group. Non‐implanted heifers were monitored on each alternate day till the confirmation of second‐ovulation in implanted heifers. Pre‐treatment period revealed the presence of dominant follicles in anoestrous heifers which attained the diameter comparable with ovulatory follicles of cycling heifers but failed to ovulate and regressed. Between 6 and 36 days (15.3 ± 2.9 days) post‐treatment, all the implanted heifers (p < 0.05) exhibited ovulation of dominant follicles; however none of the non‐implanted heifers ovulated during the corresponding period. The first‐interovulatory period in implanted heifers ranged between 8 and 28 days (18.0 ± 1.8 days). The implanted heifers with short (≤16 days) interovulatory period had short‐lived corpus luteum (CL) that had smaller diameter and secreted less progesterone (p < 0.05). The diameter of CL was large (p < 0.05) and plasma progesterone was high (p < 0.05) following second‐ovulation compared with first‐ovulation in implanted heifers. In conclusion, using melatonin implants, ovulatory size nonovulatory follicles observed in summer anoestrous buffalo heifers can be successfully ovulated to initiate ovarian cyclicity.     

MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient

Complete assessment of vertebral trauma in dogs currently requires CT and MRI for evaluation of the osseous and soft tissue structures that contribute to vertebral stability. Some studies in people have suggested that MRI may be sensitive and specific at detecting vertebral fractures making this potentially a single modality that could be used in spinal trauma evaluation. This study aimed to assess the ability for observers to evaluate vertebral fractures using MRI when compared to CT, which was used as the reference standard. Twenty‐nine dogs with previously diagnosed acute vertebral fractures and four dogs with no vertebral fracture that had undergone sequential CT and MRI were included into the study. One hundred twenty‐eight vertebrae were evaluated for the presence of fractures. Imaging studies were read by two observers blinded to the history. While both observers had similarly high sensitivity and specificity for simple detection of any fractured vertebrae, interobserver agreement was only moderate (κ = 0.584). When evaluations were specifically limited to detection of structurally unstable fractured vertebrae both observers showed improved specificity and interobserver agreement became substantial (κ = 0.650). Complete agreement for exact fracture location between MRI and CT results was only achieved in 14.3‐32.6% of fractured vertebra with up to 79% of fractures being missed in some vertebral structures. This suggests that although MRI may be able to detect the presence of fractured vertebrae, it is not able to replace CT for the complete evaluation of the traumatized spine and documentation of fracture morphology.