Felbaum Daniel R, Syed Hasan R, McCullough Michael F, Armonda Rocco A, Liu Ai-Hsi, Bell Randy S
Neurosurgery, Medstar Georgetown University Hospital, Washington DC, USA.
Neurointerventional Radiology, Medstar Washington Hospital Center, Washington DC, USA.
Cureus. 2016 Feb 7;8(2):e483. doi: 10.7759/cureus.483.
Preoperative embolization via transarterial route is an acceptable adjunct to the treatment of carotid body tumors (CBT). Direct tumor puncture for embolization has been previously described as a safe and feasible option. We revisit this technique and present our initial experience treating CBT via direct puncture. We identified six patients that underwent preoperative embolization of CBT using a direct puncture technique embolized with Onyx (EV3 Micro Therapeutics Inc., Irvine, CA, USA). After defining the angioarchitecture via digital subtraction angiography, the tumor was targeted with Onyx. Using a 21-gauge needle, the tumor was punctured using a fluoroscopic road mask. There were no immediate post-procedural complications following embolization. All patients underwent definitive resection within 24 hours. During surgery, the embolization material did not affect surgical maneuvers. In addition, the estimated blood loss was noted to average 50 ml. Although early in our experience, direct percutaneous embolization of CBT appears to be a reproducible and well-tolerated endovascular treatment option. Overall, the reported body of evidence available confirms the safety and efficacy of direct intralesional embolization with Onyx.
经动脉途径的术前栓塞是治疗颈动脉体瘤（CBT）的一种可接受的辅助方法。先前已描述直接肿瘤穿刺栓塞是一种安全可行的选择。我们重新审视了这项技术，并介绍了我们通过直接穿刺治疗CBT的初步经验。我们确定了6例使用直接穿刺技术并用Onyx（美国加利福尼亚州欧文市EV3 Micro Therapeutics公司）栓塞进行CBT术前栓塞的患者。通过数字减影血管造影确定血管结构后，用Onyx对肿瘤进行靶向栓塞。使用21号针，在荧光透视路图引导下穿刺肿瘤。栓塞后无即刻术后并发症。所有患者均在24小时内接受了根治性切除。手术过程中，栓塞材料未影响手术操作。此外，估计平均失血量为50毫升。尽管这只是我们的初步经验，但CBT的直接经皮栓塞似乎是一种可重复且耐受性良好的血管内治疗选择。总体而言，现有报道的证据证实了使用Onyx进行直接瘤内栓塞的安全性和有效性。
