Venografia da região társica de equinos higidos
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Data
2021-10-01
Autores
Torres, Daniel Leonardo Parra
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A perfusão intravenosa regional dos membros (PIVR) na clínica equina é realizada com um acesso vascular proximal, contudo, as válvulas podem se fechar e interferir na distribuição do medicamento por causa do fluxo retrogrado. O objetivo deste trabalho foi comparar o número de vasos e a exequibilidade do acesso venoso proximal, correspondente ao ramo cranial da veia saphena medialis e o acesso distal, sendo a veia digitalis dorsalis communis II, para a técnica de venografia da região do tarso de equinos hígidos. Para tanto, sete equinos adultos, machos castrados e hígidos, foram submetidos ao exame venográfico nos membros pélvicos esquerdo e direito. Os membros foram divididos em dois grupos: acesso proximal (AP) nas venografias realizadas com acesso vascular no ramo cranial da veia saphena medialis, e no grupo acesso distal (AD), as venografias foram realizadas com acesso na veia digitalis dorsalis communis II. Os animais foram contidos em tronco, sedados com cloridrato de detomidina a 1% (30 μg/kg, IV), realizado um botão anestésico com cloridrato de lidocaína a 2% (0,3 mL) sem vasoconstrictor, a cateterizarão foi realizada nas regiões de inserção com cateter 18G e após a inserção foi acoplado um plug adaptador PRN. Os torniquetes de borracha foram aplicados no terço proximal da tíbia e no terço proximal do III metatarsiano. Com seringas de 10mL e escalpe 21G, foram aplicados 30mL de contraste (ioversol 68%) e sequencialmente foram realizadas radiografias nas projeções dorso plantar (DPl), latero medial (LM), dorsolateral- plantaromedial oblíqua e dorsomedial- plantarolateral obliqua com técnica radiográfica (75 kV, 1,6 mAs e 75 cm de distância). A contagem dos vasos foi realizada colocando uma linha transversal em três locais: epífise da tíbia, tomando como referência a tuberosidade do osso calcâneo, articulação intertársica proximal e a tarsometarsica nas quatro projeções radiográficas, adicionalmente foram relatadas as inconveniências durante o procedimento. A análise estatística foi realizada utilizando o teste Kolmogorov Smirnov, para verificar a normalidade dos dados. Para comparar os valores entre o AD e AP foi aplicado o teste Mann-Whitney. A venografia de tarso com torniquete no terço médio da tíbia e no terço proximal do metatarso não apresentou diferença na contagem total de vasos entre os grupos. No grupo AD foi conseguido o 100% (6/6) dos acessos venosos, enquanto ao grupo AP foi de 23% (3/13) e 77% (10/13) dos exames realizados teve extravasamento. A avaliação da execução da técnica constatou que o acesso proximal possui um maior grau de dificuldade e está associado ao extravasamento do meio de contraste.
Regional Limb Intravenous Perfusion (PIVR) in the equine clinic is performed with a proximal vascular access, however, the valves may close and interfere with drug delivery because of retrograde flow. The objective of this study was to compare the number of vessels and the feasibility of the proximal venous access, corresponding to the cranial branch of the medialis saphena vein and the distal access, being the digitalis dorsalis communis II vein, for the venography technique of the tarsal region of horses healthy. For that, seven adult horses, castrated and healthy males, were submitted to venographic examination in the left and right pelvic limbs. The limbs were divided into two groups: proximal access (PA) in the venographs performed with vascular access in the cranial branch of the medialis saphena vein, and in the distal access (AD) group, the venographs were performed with access in the digitalis dorsalis communis II vein. The animals were contained in the trunk, sedated with 1% detomidine hydrochloride (30 μg/kg, IV), an anesthetic button performed with 2% lidocaine hydrochloride (0.3 mL) without vasoconstrictor, catheterization was performed in the regions insertion with an 18G catheter and after insertion a PRN adapter plug was attached. Rubber tourniquets were applied to the proximal third of the tibia and the proximal third of the III metatarsal. With 10mL syringes and 21G scalp, 30mL of contrast (ioversol 68%) were applied and radiographs were sequentially taken in the dorsum plantar (DPl), lateral medial (LM), dorsolateral- plantaromedial oblique and dorsomedial-plantarolateral oblique projections with radiographic technique ( 75 kV, 1.6 mAs and 75 cm distance). Vessel count was performed by placing a transverse line in three locations: tibial epiphysis, taking as reference the calcaneal bone tuberosity, proximal intertarsal and tarsometarsal joint in the four radiographic projections, additionally, inconveniences during the procedure were reported. Statistical analysis was performed using the Kolmogorov Smirnov test to verify the normality of the data. To compare the values between AD and AP, the Mann-Whitney test was applied. Tarsal venography with tourniquet in the middle third of the tibia and in the proximal third of the metatarsal showed no difference in the total vessel count between the groups. In the AD group 100% (6/6) of the venous accesses was achieved, while in 12 the AP group it was 23% (3/13) and 77% (10/13) of the exams performed had extravasation. The evaluation of the execution of the technique found that the proximal access has a greater degree of difficulty and is associated with extravasation of the contrast medium.
Regional Limb Intravenous Perfusion (PIVR) in the equine clinic is performed with a proximal vascular access, however, the valves may close and interfere with drug delivery because of retrograde flow. The objective of this study was to compare the number of vessels and the feasibility of the proximal venous access, corresponding to the cranial branch of the medialis saphena vein and the distal access, being the digitalis dorsalis communis II vein, for the venography technique of the tarsal region of horses healthy. For that, seven adult horses, castrated and healthy males, were submitted to venographic examination in the left and right pelvic limbs. The limbs were divided into two groups: proximal access (PA) in the venographs performed with vascular access in the cranial branch of the medialis saphena vein, and in the distal access (AD) group, the venographs were performed with access in the digitalis dorsalis communis II vein. The animals were contained in the trunk, sedated with 1% detomidine hydrochloride (30 μg/kg, IV), an anesthetic button performed with 2% lidocaine hydrochloride (0.3 mL) without vasoconstrictor, catheterization was performed in the regions insertion with an 18G catheter and after insertion a PRN adapter plug was attached. Rubber tourniquets were applied to the proximal third of the tibia and the proximal third of the III metatarsal. With 10mL syringes and 21G scalp, 30mL of contrast (ioversol 68%) were applied and radiographs were sequentially taken in the dorsum plantar (DPl), lateral medial (LM), dorsolateral- plantaromedial oblique and dorsomedial-plantarolateral oblique projections with radiographic technique ( 75 kV, 1.6 mAs and 75 cm distance). Vessel count was performed by placing a transverse line in three locations: tibial epiphysis, taking as reference the calcaneal bone tuberosity, proximal intertarsal and tarsometarsal joint in the four radiographic projections, additionally, inconveniences during the procedure were reported. Statistical analysis was performed using the Kolmogorov Smirnov test to verify the normality of the data. To compare the values between AD and AP, the Mann-Whitney test was applied. Tarsal venography with tourniquet in the middle third of the tibia and in the proximal third of the metatarsal showed no difference in the total vessel count between the groups. In the AD group 100% (6/6) of the venous accesses was achieved, while in 12 the AP group it was 23% (3/13) and 77% (10/13) of the exams performed had extravasation. The evaluation of the execution of the technique found that the proximal access has a greater degree of difficulty and is associated with extravasation of the contrast medium.
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Palavras-chave
Angiografia, Articulações társianas, Flebografia, Válvulas venosas, Angiography, Tarsian joints, Phlebography