A Hybrid Approach Towards Successful Resection of a Huge Carotid Body Paraganglioma Using Coil Embolization and Traditional Surgical Techniques

Janakiram, Trichy Narayanan; Nadakkavukaran, Joseph; Sharma, Shilpee Bhatia; Sathyanarayanan, J D

doi:10.1007/s12070-018-1516-z

Cited by 6 publications

(6 citation statements)

References 24 publications

(19 reference statements)

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“…There are few reports on the use of microcoils in preoperative embolization of paragangliomas and AVMs of soft tissues of the head. The main described advantage of preoperative embolization with microcoils is the ability of palpatory detection of them during surgery and the absence of risks of distal embolism [7]. The disadvantages include the high cost of microcoils [28].…”

Section: Discussionmentioning

confidence: 99%

“…Minimally invasive procedures are becoming increasingly popular in the management of benign hypervascularized masses located in the head and neck regions [1][2][3][4][5]. Embolization is a method of blocking the blood supply to these masses, and can be implemented for preparation before open surgical removal [5][6][7], to decrease blood supply prior to radiosurgery [8], or as a standalone treatment option [9].…”

Section: Introductionmentioning

confidence: 99%

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The Advantages of Non-Adhesive Gel-like Embolic Materials in the Endovascular Treatment of Benign Hypervascularized Lesions of the Head and Neck

Petrov,

Ivanov,

Kolomin

et al. 2023

Gels

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Objectives: The use of non-adhesive gel-like embolic materials (NAGLEMs) in the endovascular treatment of hypervascularized formations in the head and neck is gaining in popularity because of a number of important characteristics involved. Their primary benefits are their capacity to penetrate diseased vasculature, effectively distribute, and, most importantly, remain controllable during the process. We reviewed the literature and evaluated the results of using NAGLEMs in comparison to other embolizing substances (namely, coils, glue, and particles) as alternative embolizing agents for patients receiving care at our clinic. The process comprised evaluating the safety, effectiveness, and technological elements of endovascular therapy used to treat two categories of hypervascular pathological abnormalities that were surgically corrected between 2015 and 2023. Arteriovenous malformations (AVMs) located in the head, neck, and paragangliomas with jugular/carotid body localization are combined by intense shunting blood flow and shared requirements for the embolic agent used in endovascular treatment (such as penetration, distribution, delayed polymerization, and controllability). An analysis of the literature was also conducted. Results showed 18 patients diagnosed with neck paragangliomas of the carotid body and jugular type. Five patients with arteriovenous malformation (AVM) of the face and neck were included, consisting of sixteen females and seven males with an average age of 55 ± 13 years. Endovascular procedures were performed using NAGLEMs (ONYX (Medtronic, Irvine, CA, USA), SQUID (Balt, Montmorency, France), and PHIL (Microvention, Tustin, CA, USA)) and dimethyl sulfoxide (DMSO)-compatible balloon catheters. All patients achieved complete or partial embolization of hypervascularized formations using one or more stages of endovascular treatment. Additionally, three AVMs of the face and two paragangliomas of the neck were surgically excised following embolization. In other instances, formations were not deemed necessary to be removed. The patients’ condition upon discharge was assessed by the modified Rankin Scale (mRs) and rated between 0 and 2. Conclusion: Currently, NAGLEMs are predominantly used to treat hypervascularized formations in the neck and head due to their fundamental properties. These properties include a lack of adhesion and a delay in predictable polymerization (after 30–40 min). NAGLEMs also exhibit excellent distribution and penetration throughout the vascular bed of the formation. Adequate controllability of the process is largely achieved through the presence of embolism forms of different viscosity, as well as excellent X-ray visualization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Advantages of Non-Adhesive Gel-like Embolic Materials in the Endovascular Treatment of Benign Hypervascularized Lesions of the Head and Neck

Petrov,

Ivanov,

Kolomin

et al. 2023

Gels

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“…Unlike liquid agents, fully detachable coils have greater control and when handled appropriately, can be less likely to be associated with nontarget embolization. 25 , 27 This greater control can enhance precision of deployment and may mitigate the need for ECA sacrifice at the time of embolization. 3 The precision of our coil placement was underscored by coils discovered in ligated tumor-feeding vessels during open resection.…”

Section: Discussionmentioning

confidence: 99%

Superselective carotid body tumor embolization with platinum-based coils

Bellamkonda

Chen

Tonnessen

et al. 2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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Resection of Shamblin II and III carotid body tumors can be challenging owing to the potential for significant blood loss. Prophylactic use of liquid embolic agents poses a risk of inflammatory reactions and nontarget embolization. On the other hand, coil embolization has traditionally been limited to cases involving external carotid artery sacrifice. Herein we demonstrate that superselective targeting of tumor-feeding vessels using platinum based, fully detachable packing coils is effective at sustained devascularization of Shamblin II and III carotid body tumors without subsequent inflammation, allowing for a longer interval between embolization and tumor resection, and potentially reducing blood loss without need for ligation or reconstruction of the internal or external carotid artery.

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“…Clinical and radiological follow-up was scheduled as follows: clinical examination and head and neck contrast-enhanced MRI every year for the first five years, then every two years until the 10 th year for sporadic tumours, then every 5 years during the following years for familial or syndromic cases 19 . In these latter cases of familial or multiple tumours, follow-up was completed with chest x-ray, contrast-enhanced total-body CT scan and, more recently, 68 Ga-DOTATATE PET.…”

Section: Methodsmentioning

confidence: 99%

Microsurgery in carotid body paraganglioma

Mazzoni,

Franz,

Zanoletti

2024

Acta Otorhinolaryngol Ital

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SUMMARY Objectives In carotid paraganglioma surgery, magnification is crucial to properly evaluate the anatomical relationships between mass, carotid wall, cranial nerves, tumour vascular supply and fascial envelope. The aims of this study are to describe the microsurgical technique, along with the underlying microsurgical anatomy, and to assess outcomes in terms of disease control, complications and functional results. Methods Twenty-six patients, accounting for 29 carotid paragangliomas, treated with microsurgery by the same senior surgeon over a 35-year period, were included. Results No carotid injury requiring repair, nor peri- or post-operative stroke occurred in this series. No surgical injury of the main trunk of VII to XII cranial nerves occurred. Complete excision was obtained in all cases and no recurrence was observed during follow-up. Conclusions The small study size and its retrospective nature suggests caution; however, our results show that microsurgery can allow a safe and precise dissection of the carotids and nerves.

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A Hybrid Approach Towards Successful Resection of a Huge Carotid Body Paraganglioma Using Coil Embolization and Traditional Surgical Techniques

Cited by 6 publications

References 24 publications

The Advantages of Non-Adhesive Gel-like Embolic Materials in the Endovascular Treatment of Benign Hypervascularized Lesions of the Head and Neck

The Advantages of Non-Adhesive Gel-like Embolic Materials in the Endovascular Treatment of Benign Hypervascularized Lesions of the Head and Neck

Superselective carotid body tumor embolization with platinum-based coils

Microsurgery in carotid body paraganglioma

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