Preoperative Angiography and Transarterial Embolization in the Management of Carotid Body Tumor: A Single-Center, 10-Year Experience

• Published in: Neurosurgery Vol. 67; no. 4; pp. 941 - 948
• Main Authors: Li, Jiaping, Wang, Shenming, Zee, Chishing, Yang, Jianyong, Chen, Wei, Zhuang, Wenquan, Li, Xiaoxi, Lv, Weiming, Huang, Yonghui, Li, Songqi
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Oxford University Press 01.10.2010; Lippincott Williams & Wilkins; Wolters Kluwer Health, Inc
• Subjects: Adult; Aged; Angiography - methods; Biological and medical sciences; Carotid Body Tumor - diagnostic imaging; Carotid Body Tumor - surgery; Embolization, Therapeutic - methods; Female; Humans; Longitudinal Studies; Magnetic Resonance Imaging - methods; Male; Medical imaging; Medical sciences; Middle Aged; Neuroendocrine tumors; Neurosurgery; Preoperative Care; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, X-Ray Computed - methods; Treatment Outcome; Tumors; Young Adult; Angiography; Embolization; Carotid body tumor; Nervous system diseases; Clinical management; Surgery; Tumor; Preoperative; Carotid body
• ISSN: 0148-396X; 1524-4040
• DOI: 10.1227/NEU.0b013e3181eda61d

Abstract 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 ± 2.1days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5days 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. CONCLUSION: 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.