Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
Neuroradiology. 2013 Sep;55(9):1113-8. doi: 10.1007/s00234-013-1220-3. Epub 2013 Jun 22.
Preoperative embolization of a carotid body tumor (CBT) is a useful adjunct prior to surgical excision because it decreases operative blood loss and improves surgical outcomes. Traditionally, this is performed by transarterial particulate embolization (TAPE). More recently, direct percutaneous embolization (DPE) with Onyx is recognized as a promising technique for preoperative embolization. We compared these two techniques in patients treated for CBTs at our institution.
We retrospectively reviewed cases of preoperative devascularization of CBT from 1 January 1995 through 1 September 2012. Patient cases were placed into two groups: TAPE and DPE. Operative blood loss, operative length, angiographic devascularization, embolization procedure complications, operative transfusion requirements, postoperative hospital stay, intensive care unit (ICU) stay, and procedure-related mortalities were compared.
A total of 17 patients underwent preoperative devascularization of their CBT with TAPE technique and ten patients using the DPE technique with Onyx. Average operative blood loss was significantly higher in the TAPE group (Mann-Whitney U test, p = 0.04). Operative time was also higher, although this difference was not significant. Two patients required intraoperative blood transfusions in the TAPE group while none required transfusions in the DPE group. There was no significant difference in ICU stay or length of hospitalization. One serious embolization procedure complication occurred in the TAPE group and none in the DPE group.
Operative blood loss in the DPE group was significantly less than the TAPE group. Blood transfusion requirement, operative time, and complications were less in the DPE group, although they did not reach statistical significance.
颈动脉体肿瘤（CBT）术前栓塞是在手术切除前的一种有用的辅助手段，因为它可以减少手术中的出血量并改善手术结果。传统上，这是通过经动脉微粒栓塞（TAPE）来完成的。最近，Onyx 的直接经皮栓塞（DPE）被认为是一种有前途的术前栓塞技术。我们比较了在我们机构接受 CBT 治疗的患者中这两种技术。
我们回顾性地研究了 1995 年 1 月 1 日至 2012 年 9 月 1 日期间接受 CBT 术前血运重建的病例。将患者分为两组：TAPE 组和 DPE 组。比较手术失血量、手术时间、血管造影血运重建、栓塞程序并发症、手术输血需求、术后住院时间、重症监护病房（ICU）住院时间和与程序相关的死亡率。
共有 17 例患者接受 TAPE 技术术前 CBT 血运重建，10 例患者接受 DPE 技术用 Onyx 进行术前血运重建。TAPE 组的平均手术失血量明显更高（Mann-Whitney U 检验，p=0.04）。手术时间也较高，但差异无统计学意义。TAPE 组有 2 例患者在术中需要输血，而 DPE 组无一例需要输血。ICU 住院时间和住院时间无显著差异。TAPE 组发生 1 例严重栓塞程序并发症，DPE 组无并发症。
DPE 组的手术失血量明显少于 TAPE 组。DPE 组的输血需求、手术时间和并发症较少，但未达到统计学意义。
