Preoperative angiography and transarterial embolization in the management of carotid body tumor: a single-center, 10-year experience.
BACKGROUND
Sixty percent of paragangliomas are located unilaterally at the carotid bifurcation. These are referred to as carotid body tumors (CBTs).


OBJECTIVE
To present our 10-year experience in the management of patients with CBTs, and to evaluate the efficacy of angiography and preoperative embolization technique in this retrospective study.


METHODS
Sixty-two patients with surgically removed CBTs (Shamblin class II and III), were divided into two groups. Group I, the preoperative embolization group, included 33 patients with 11 class II lesions and 25 class III lesions. Group II, the group that had surgery only, without preoperative embolization, included 29 patients with 9 class II lesions and 21 class III lesions. Comparisons were made between the groups in terms of mean intraoperative blood loss, mean operation time, mean postoperative hospital stay, and clinical complications.


RESULTS
In group I, post-embolization angiography demonstrated complete tumor devascularization in 25 (76%) lesions and partial devascularization in 11 (24%) lesions. All but 1 (2%) lesion were completely excised. Mean intraoperative blood loss, mean operation time, and mean hospital stay were 354.8 ± 334.4 mL, 170.3 ± 75.4 min, 8.0 ± 2.1 days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5 days in group II, respectively. In group II, 27 lesions (91%) were completely removed. The transient ischemic attack (TIA) and cranial nerve injury incidence rates were 10.3% and 13.8% in group II and only 3% for TIA in group I.


CONCLUSIONS
These results suggest angiography is highly valuable for the diagnosis of CBT. Preoperative selective embolization of CBT is an effective and safe adjunct for surgical resection, especially for Shamblin class II and III tumors.
Li
Jiaping
J
Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Wang
Shenming
S
Zee
Chishing
C
Yang
Jianyong
J
Chen
Wei
W
Zhuang
Wenquan
W
Li
Xiaoxi
X
Lv
Weiming
W
Huang
Yonghui
Y
Li
Songqi
S
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D002345:Carotid Body Tumor / Q000000981:diagnostic imaging* / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult