Kafie F E, Freischlag J A
UCLA Gonda (Goldschmied) Vascular Center, UCLA Medical Center, 200 Medical Plaza, Los Angeles, CA 90095, USA.
Ann Vasc Surg. 2001 Mar;15(2):237-42. doi: 10.1007/s100160010058. Epub 2001 Mar 1.
Resection of carotid body tumors (neck paragangliomas) carries inherent risks of injury to the cranial nerves and other structures as well excessive blood loss. Preoperative embolization has been used to lessen the morbidity in tumors that are larger than 2 cm in diameter. Two female patients presented for treatment with large asymptomatic carotid body tumors-one 4 cm and one 5 cm in diameter. Both patients had preoperative angiography the day before surgery that revealed the feeding arterial vessels so that successful embolization could be accomplished with gel. Success was judged by diminution of the angiographic blush. Both patients had an uneventful surgical excision the following day with the carotid body tumors being able to be resected periadventitially without damage to either the external or internal carotid artery. The cranial nerves were preserved in both patients and blood loss was only 200 cc in both cases. We conclude that preoperative embolization is an important adjunct in treating patients with large carotid body tumors. The surgical exploration proceeds much smoother, the blood loss is minimal, and patients have minimal morbidity.
切除颈动脉体瘤（颈部副神经节瘤）存在损伤颅神经和其他结构以及失血过多的固有风险。术前栓塞已被用于降低直径大于2厘米的肿瘤的发病率。两名女性患者因患有大型无症状颈动脉体瘤前来接受治疗，一个直径为4厘米，另一个直径为5厘米。两名患者在手术前一天均进行了术前血管造影，显示了供血动脉血管，以便能够用凝胶成功进行栓塞。通过血管造影造影剂充盈缺损的减少来判断是否成功。两名患者在第二天均顺利进行了手术切除，颈动脉体瘤能够在动脉外膜周围切除，而不会损伤颈外动脉或颈内动脉。两名患者的颅神经均得以保留，且两例患者的失血量均仅为200毫升。我们得出结论，术前栓塞是治疗大型颈动脉体瘤患者的重要辅助手段。手术探查进行得更加顺利，失血量极少，患者的发病率也很低。
