A safer endovascular technique for pre-operative embolization of juvenile nasopharyngeal angiofibroma : avoiding the pitfalls of external carotid artery - internal carotid artery anastomoses

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Intra-arterial embolization of juvenile nasopharyngeal angiofibroma (JNA) prior to surgical resection is the preferred approach to minimize blood loss during surgical resection of the tumor. However, the presence of external carotid artery-internal carotid artery (ECA-ICA) anastomoses may hinder complete tumor embolization due to the associated risk for embolic complications. Here, we evaluate the use of a balloon-assisted embolization (BAE) technique in the treatment of JNA. We conducted a retrospective review of JNA patients who underwent tumor embolization with injection of Onyx in a single session between 2013-2018. All cases displayed tumor arterial supply from ECA and ICA circulations on 2-D catheter angiograms. Procedural and surgical outcome data were analyzed. Results are given as mean±standard deviation (range). Among 9 patients with JNA, all were males and mean age was 14.1±6.3 years (range, 9-29 years). The mean tumor volume embolization was 84.4±12.4% (range, 60-100%) and in 89% patients ≥80% of tumor volume embolization was achieved. There were no embolization-related complications reported. During surgical resection of the tumor there was a low average surgical blood loss of 722±651.5 mL (range, 50-2,000 mL) and the mean procedure time was 282.6±85.4 mins (range, 151-403 mins). In this series, the BAE technique showed to be a safe and effective approach to achieve successful tumor embolization while avoiding embolic complications and effectively reducing the risk for blood loss during surgical resection.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:22

Enthalten in:

Journal of cerebrovascular and endovascular neurosurgery - 22(2020), 2 vom: 09. Juni, Seite 97-105

Sprache:

Englisch

Beteiligte Personen:

Rosenbaum-Halevi, David [VerfasserIn]
Lopez-Rivera, Victor [VerfasserIn]
Turkmani, Ali [VerfasserIn]
Sanzgiri, Aditya [VerfasserIn]
Zeineddine, Hussein A [VerfasserIn]
Luong, Amber [VerfasserIn]
Chen, Peng Roc [VerfasserIn]

Links:

Volltext

Themen:

Anastomosis
Balloon-assisted
Embolization
Journal Article
Juvenile nasal angiofibroma
Surgical resection
Technique

Anmerkungen:

Date Revised 28.09.2020

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.7461/jcen.2020.22.2.97

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM312424256