PREOPERATIVE EMBOLIZATION OF CAROTID-BODY TUMORS - A METHOD FOR INCREASING TUMOR OPERABILITY

During surgical resections carotid body tumors may bleed profusely due to their vascularity. Preoperative angiographic embolization of tumor -supplying arteries has reduced intraoperative blood loss significantl y. The present study reviews our clinical experiences with 13 paragang liomas of the carotid bifurcation in 12 patients during the past 5 yea rs. In 6 patients (46.1%) computed tomography and magnetic resonance i maging demonstrated extensive spread of the tumor up to the base of th e skull. Tumors of this size were initially assessed as being inoperab le but curative surgical resections were performed after embolization of tumor-supplying arteries by intravascular injections of Gelfoam and implantations of microcoils. Vascular reconstruction of the internal carotid artery by a saphenous vein graft was required in 4 patients (3 0.7%). In 3 malignant paragangliomas (23.0%) adjuvant radiotherapy of 50-60 Gy was administered to the tumor site after surgery. During an a verage follow-up of 29 months, one malignant paraganglioma was found t o have recurred locally 13 months after initial therapy.