Fırat University, Faculty of Medicine, Department of Radiology - Elâzığ, Turkey.
Rev Assoc Med Bras (1992). 2024 Aug 16;70(8):e20240371. doi: 10.1590/1806-9282.20240371. eCollection 2024.
Preoperative embolization of paragangliomas decreases tumor volume and reduces intraoperative blood loss. This study aimed to evaluate the effect of the rate of devascularization achieved by preoperative embolization of carotid body tumors on surgical outcomes.
Patients with carotid body tumors who underwent preoperative transarterial embolization between 2013 and 2024 were included in this retrospective study. The Shamblin classification of all patients was carried out using radiological imaging. Devascularization rates obtained after the embolization of carotid body tumors were determined from angiographic images. Patients were divided into two groups: near-complete embolization (devascularization rate >90%) and incomplete embolization (devascularization rate <90%). Hemoglobin loss was calculated with blood tests before and immediately after surgery. Tumor volume loss was calculated by preoperative radiological tumor volume and postoperative surgical specimen volume. Hemoglobin loss, tumor volume loss, and postoperative complication rates of the two groups were compared.
A total of 31 patients with carotid body tumors who underwent surgery were included in the study. Near-complete embolization was achieved in 21 patients (67.74%), while incomplete embolization was achieved in 10 patients (32.25%). Shamblin classification was statistically similar (p>0.05) between the two groups. The vascular complication rate in the near-complete embolization group was significantly lower than in the incomplete embolization group (p=0.027). However, no significant difference was observed in neurological complication rates, hemoglobin loss, and tumor volume loss parameters between the two groups (p>0.05).
The preoperative devascularization rate should be at least 90% to minimize the risk of vascular complications.
嗜铬细胞瘤的术前栓塞可减少肿瘤体积并降低术中出血量。本研究旨在评估颈动脉体瘤术前栓塞达到的去血管化率对手术结果的影响。
本回顾性研究纳入了 2013 年至 2024 年间接受术前经动脉栓塞治疗的颈动脉体瘤患者。所有患者均通过影像学进行 Shamblin 分级。从血管造影图像确定颈动脉体瘤栓塞后的去血管化率。将患者分为两组：近完全栓塞（去血管化率>90%）和不完全栓塞（去血管化率<90%）。通过术前和术后即刻的血液检查计算血红蛋白丢失量。通过术前影像学肿瘤体积和术后手术标本体积计算肿瘤体积丢失量。比较两组的血红蛋白丢失量、肿瘤体积丢失量和术后并发症发生率。
本研究共纳入 31 例接受手术治疗的颈动脉体瘤患者。21 例（67.74%）患者达到近完全栓塞，10 例（32.25%）患者达到不完全栓塞。两组 Shamblin 分级无统计学差异（p>0.05）。近完全栓塞组血管并发症发生率明显低于不完全栓塞组（p=0.027）。然而，两组在神经并发症发生率、血红蛋白丢失量和肿瘤体积丢失量参数方面无显著差异（p>0.05）。
术前去血管化率应至少达到 90%，以最大限度降低血管并发症的风险。
