Manelfe C, Picard L, Bonafé A, Roland J, Sancier A, l'Espérance G
Neuroradiology. 1978;16:395-8. doi: 10.1007/BF00395315.
The authors report 169 therapeutic embolizations in cases of tumoral lesions in the craniocerebral, ENT, and vertebrospinal territories. Most endovascular occlusions performed for tumoral processes are presurgical indications, with the aim of reducing hemorrhage at operation. Embolization becomes practically mandatory for nasopharyngeal angiofibromas, considerably reducing the peroperative bleeding. Indications of embolization for meningiomas must be discussed according to the size and location of the tumors: embolization is especially useful in large tumors or those inserted on the base of the skull, mainly in the middle fossa. In chemodectomas, embolization can be used presurgically or on its own when surgery becomes impossible; angiographic follow-up shows that secondary repermeabilization is frequent in spite of clinical improvement. In malignant tumors of the craniofacial region, indications of embolization must be considered with care because failure of vascularization tends to make radiotherapy less efficient; in these cases, embolization can be useful in reducing pain or to contend with cataclysmal hemorrhages.
作者报告了169例在颅脑、耳鼻喉和脊柱区域肿瘤性病变的治疗性栓塞病例。大多数针对肿瘤性病变进行的血管内闭塞是手术前的适应证,目的是减少手术中的出血。对于鼻咽血管纤维瘤,栓塞实际上成为必需,可显著减少术中出血。对于脑膜瘤,栓塞的适应证必须根据肿瘤的大小和位置进行讨论:栓塞在大型肿瘤或位于颅底(主要是中颅窝)的肿瘤中特别有用。在化学感受器瘤中,栓塞可在术前使用,或者在无法进行手术时单独使用;血管造影随访显示,尽管临床症状有所改善,但继发性再通很常见。在颅面部恶性肿瘤中,必须谨慎考虑栓塞的适应证,因为血管化的失败往往会使放疗效果降低;在这些情况下,栓塞可有助于减轻疼痛或应对灾难性出血。