CAROTID OCCLUSION WITHOUT RECONSTRUCTION - A SAFE SURGICAL OPTION IN SELECTED PATIENTS

Complete resection of extensive skull base tumors can be difficult whe n the disease involves or is closely related to the carotid artery. De tachable balloons have been used effectively to permanently occlude th e carotid artery prior to anticipated surgical resection, but their us e involves risk of significant cerebral complications. To better defin e the risks and benefits of this procedure, 52 patients who underwent balloon occlusion of the carotid artery followed by surgery with resec tion of a portion of the carotid artery were retrospectively reviewed. Pathologic findings are presented demonstrating the infiltrative natu re of many of these tumors and the difficulty in separating histologic ally benign tumors from the carotid artery when they are closely relat ed to it. Although vascular reconstruction can be considered whenever carotid occlusion or resection is planned, balloon occlusion without r econstruction can be safely performed in selected patients, avoiding u nnecessary and hazardous additional surgery.