[Use of the GDC for embolization of a tumor fed by a cavernous branch of the internal carotid artery].
Currently, embolization of small branches of the internal carotid artery (ICA) can be embolized through superselective microcatheterization, followed by the injection of liquid or particulate embolic materials. Often, however, a microcatheter cannot be placed in a stable enough position to allow an endovascular surgeon to perform a safe embolization, and the reflux of embolic agents into the main trunk of the ICA is a major concern. Meticulous technique and a detailed knowledge of the vascular anatomy of the cavernous sinus region are necessary to maximize devascularization of the lesion and to minimize the risk of complications. This report describes the case of a patient with a hypervascular tumor whose feeding vessel from the cavernous ICA was successfully occluded with polyvinyl alcohol (PVA) combined with a regular Guglielmi detachable coil (GDC). A 62-year-old woman had a left-sided petroclival meningioma, which was diagnosed based on computed tomography and magnetic resonance studies. Transfemoral angiographic studies demonstrated that the tumor was fed by intracavernous branches of the left ICA. We believed that another embolic agent would have presented a risk of reflux into the ICA, with possible unwanted occlusion of normal intracranial arteries. A single GDC was sufficient to occlude the feeding artery, and the patient underwent successful surgery 3 days after the endovascular procedure. The GDC can eliminate the ICA supply to hypervascular tumors safely when liquid or particle embolic materials would present a risk of reflux into normal arteries. This device can be positioned and repositioned and can be detached without mechanical force. It may also decrease the risk of unwanted embolization of normal intracranial arteries.
Katsumata
A
A
Department of Neurological Surgery, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Kusaka
N
N
Sugiu
K
K
Nakashima
H
H
Date
I
I
Ohmoto
T
T
D002343:Carotid Artery, Internal; D003388:Cranial Fossa, Posterior; D003399:Craniotomy / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000098:blood supply / Q000628:therapy*; D008579:Meningioma / Q000098:blood supply / Q000628:therapy*; D008875:Middle Aged; D010579:Petrous Bone