A Case of Aortic Thromboembolism in a Cat: Application of Catheter-Directed Balloon Thrombectomy

Feline aortic thromboembolism is a critical vascular emergency characterized by the acute onset of hindlimb paralysis, severe pain, and loss of femoral pulses, requiring rapid intervention. In this article, a case of aortic thromboembolism identified in a 4-year-old neutered male cat presenting with bilateral hindlimb paralysis was discussed in terms of diagnostic and treatment protocols. Contrast-enhanced computed tomography findings revealed the presence of a trifurcation thrombus affecting perfusion to both hindlimbs, in accordance with physical examination findings suggestive of bilateral loss of blood flow. The patient was considered high risk for open surgical arterial thrombectomy due to existing metabolic disturbances and hemodynamic instability. For this reason, fluoroscopically guided catheter-directed balloon thrombectomy, a minimally invasive approach, was preferred in the treatment protocol. Although the Fogarty catheter used for this purpose is primarily applied in human medicine, in the present case a balloon thrombectomy technique was used under fluoroscopic guidance, with controlled inflation adjusted to the diameter of the feline femoral artery. In this patient, which was evaluated as an emergency case, the procedure was initially performed on the right femoral artery. Following the procedure, blood flow toward the right side was successfully restored. However, after this initial intervention, the patient’s condition acutely deteriorated, and balloon thrombectomy of the left femoral artery was not performed. The patient was transferred to the intensive care unit. But, the cat died during the early postoperative period due to the preoperative potential metabolic burden and likely ischemia–reperfusion injury. This case emphasizes that minimally invasive catheter-directed balloon thrombectomy may represent a potential alternative in the emergency treatment of high-risk acute feline aortic thromboembolism and highlights the importance of careful clinical management during the post-reperfusion period.