[Main anastomoses of external carotid artery branches with the beds of the internal carotid and the vertebral artery and a role of pharmacological tests in the determination of their functional value at tumor embolization].
In 21 patients with meningovascular tumors (meningiomas, angiofibromas, etc.), 53 vessels were tested during preoperative embolization of extracranial tumors. Two groups of drugs were superselectively intraarterially administered in turn--first barbiturates, such as thiopental sodium, 15-20 mg in 2 ml of sodium chloride solution, to detect anastomoses with cerebral vessels, then local anesthetics (lidocaine, 10-20 mg in 2 ml of sodium chloride solution, to reveal the vessels feeding cranial nerves. If drug tests were negative, the afferent was embolized with under 300 microns particles. If they were positive this was done with only large particles (above 300 microns). Injection of thiopental sodium into the occipital artery provided a positive result in 1 (1.8%) of the 53 cases. There were no complications after negative tests, followed by embolization. Drug provocative tests during embolization of the vessels feeding extra- and intracranial tumors make it possible to reduce the risk for persistent ischemic events associated with the entry of artificial emboli into the cerebral vessels and vasa nervorum and to conduct the optimum embolization of afferents.
F A
FA
Serbinenko
A G
AG
Lysachev
S R
SR
Arustamian
D000779:Anesthetics, Local / Q000008:administration & dosage; D018322:Angiofibroma / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery; D001163:Arteriovenous Anastomosis / Q000601:surgery; D001463:Barbiturates / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery; D002339:Carotid Arteries / Q000473:pathology; D002342:Carotid Artery, External / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D007269:Injections, Intra-Arterial; D008012:Lidocaine / Q000008:administration & dosage; D008577:Meningeal Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery; D008579:Meningioma / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery; D009460:Neurologic Examination; D009880:Ophthalmic Artery / Q000473:pathology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D013874:Thiopental / Q000008:administration & dosage
D000779:Anesthetics, Local; D001463:Barbiturates; D008012:Lidocaine; D013874:Thiopental