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J Am Vet Med Assoc. 2019 Apr 1;254(7):843-851. doi: 10.2460/javma.254.7.843.

Catheter occlusion of the dorsal sagittal sinus-confluens sinuum to enable resection of lateral occipital multilobular osteochondrosarcoma in two dogs.

Abstract

CASE DESCRIPTION:

A 6-year-old neutered male mixed-breed dog (dog 1) and 5-year-old neutered male Boston Terrier (dog 2) were evaluated because of lateralized multilobular osteochondrosarcoma (MLO) of the occiput.

CLINICAL FINDINGS:

Diagnostic imaging revealed proliferative bony occipital masses in both dogs and a nodule in the right caudal lung lobe of dog 1. For both dogs, MRI revealed intact flow through the dorsal sagittal sinus (DSS) into 1 transverse sinus.

TREATMENT AND OUTCOME:

In dog 1, a 4F balloon catheter was introduced into the DSS to the confluens sinuum (CS) and inflated over 16 hours to occlude venous flow. The mass with the CS was removed 24 hours later, and the skull was reconstructed. The dog was discharged from the hospital 2 days after surgery and survived 17 months before euthanasia because of metastasis. In dog 2, balloon catheter insertion into the DSS failed, and a 3.5F rubber catheter was placed up to the CS to occlude flow. The occiput with MLO was removed 48 hours after catheterization, and the skull was reconstructed. Dog 2 was discharged from the hospital after 3 days and was doing well 15 months later.

CLINICAL RELEVANCE:

Findings for these 2 dogs suggested that deliberate preoperative occlusion of the DSS and CS allows successful resection of occipital neoplasms across the midline. Without prior occlusion of the DSS, development of lethal cerebral edema would have been likely. Gradual balloon catheter occlusion of the CS may facilitate challenging occipital mass excisions.

PMID:
30888273
DOI:
10.2460/javma.254.7.843

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