Hu Min, Zhang Li-hai, Yang Ge, Chen Li-jie, Zhan Xiong
Dept. of Stomatology, Chinese PLA General Hospital, Beijing 100853, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2010 Aug;28(4):387-90.
To investigate the value of carotid arteriography and selective embolization in surgical treatment of carotid body tumor.
Seven patients with carotid body tumor were operated, and four patients were performed with carotid arteriography and selective embolization before operation. All patients were treated by stripping the carotid body tumor from the carotid artery. Treatment effectiveness of the patients with and without selective embolization were compared.
Seven cases were classified as Shamblin III type. The CT scan and digital subtraction angiography (DSA) showed the tumor lesion in the carotid bifurcation, and the tumor and its relation with the surrounding arteries were expressed by CT and three dimensional CT images. All cases of carotid body tumor were resected without any carotid artery ligation. No serious complications occurred after operation. There was average 160 mL blood loss in operation of four patients that had angiograms and were preoperatively embolized, and average 2.5 h were expended. There was average 600 mL blood loss in operation of three patients without preoperatively embolized, and average 4 h were expended. Preoperatively high-selected embolization of the tumor-feeding artery could effectively reduce the intraoperative bleeding. With 1.5-3 years follow-up, none of the carotid body tumor recurred in all the seven cases.
Carotid arteriography and embolization therapy may decrease blood loss and higher risk for operation in the patients with carotid body tumor.
探讨颈动脉造影及选择性栓塞在颈动脉体瘤手术治疗中的价值。
对7例颈动脉体瘤患者行手术治疗，其中4例患者在术前进行了颈动脉造影及选择性栓塞。所有患者均采用从颈动脉剥离颈动脉体瘤的方法进行治疗。比较有选择性栓塞和无选择性栓塞患者的治疗效果。
7例均为Shamblin III型。CT扫描及数字减影血管造影（DSA）显示肿瘤位于颈动脉分叉处，CT及三维CT图像显示了肿瘤及其与周围动脉的关系。所有颈动脉体瘤病例均在未结扎任何颈动脉的情况下切除。术后未发生严重并发症。4例行血管造影并术前栓塞的患者手术平均失血160 mL，平均耗时2.5小时。3例未术前栓塞的患者手术平均失血600 mL，平均耗时4小时。术前对肿瘤供血动脉进行高选择性栓塞可有效减少术中出血。随访1.5 - 3年，7例患者中无一例颈动脉体瘤复发。
颈动脉造影及栓塞治疗可减少颈动脉体瘤患者的术中失血及手术风险。
