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

This technical note describes the use of a manual graphic roadmap (MGR) to assist fluoroscopic guidance during transarterial coil embolization (TACE) for guttural pouch (GP) arterial hemorrhage. Horses underwent MGR-assisted TACE at the Equine Clinic, Free University of Berlin, between 2012 and 2024. Surgery was performed under general anesthesia with fluoroscopic guidance. Following the initial angiogram, a transparent foil was secured to the fluoroscopy monitor, and an assistant traced the vascular anatomy with a waterproof marker to create the MGR, which then served as a guide for catheter advancement and coil placement. This technique was applied in all TACE procedures performed at the authors' institution. The MGR provided continuous anatomical orientation throughout catheter navigation and coil placement; additional contrast injections were required only to confirm vessel occlusion. We describe a practical approach to support anatomical orientation during TACE in settings without access to fluoroscopy with roadmap technology. Further studies should evaluate cases treated with this technique and assess subjective and objective procedural parameters, including contrast usage, radiation exposure, and overall efficiency, under standardized model conditions.