Rana Rohini, Chahine Ahmad, Morsi Rami Z, Thind Sonam, Desai Harsh, Kothari Sachin A, Baskaran Archit, Falk Sophia, Karar Lina, Polster Sean P, Siegler James E, Coleman Elisheva R, Brorson James R, Mansour Ali, Prabhakaran Shyam, Kass-Hout Tareq
Department of Neurology, University of Chicago, Chicago, IL, USA.
Department of Neurosurgery, University of Chicago, Chicago, IL, USA.
Interv Neuroradiol. 2025 Jul 21:15910199251359084. doi: 10.1177/15910199251359084.
BackgroundCarotid body tumors (CBTs) are neuroendocrine tumors that arise from the carotid body. The malignant cases can present with a multitude of complications. Thus, surgical resection is the preferred treatment of choice. However, preoperative embolization is an established adjuvant treatment, especially with larger and symptomatic tumors. Current devascularization practice includes numerous techniques and materials, such as using liquid or embolic materials to embolize feeding vessels, coil embolization, direct tumor puncture, and covered stent placement. In this case series, we present our initial experience in pre-treatment of CBTs using a combined approach of established embolization techniques and balloon occlusion of the external carotid artery (ECA) via the EMBOGUARD Balloon Guide Catheter (Johnson & Johnson Neurovascular, Irvine, CA).MethodsWe performed a retrospective review of medical records from March 2023 to February 2024, including patients over 18 years old diagnosed with a carotid body tumor who had pre-operative embolization using the EMBOGUARD Balloon Guide Catheter. The primary outcome measure was the degree of angiographic devascularization achieved. Safety outcomes included procedural complications, such as non-target embolization into previously uninvolved territories and cranial nerve deficits.ResultsWe included three cases in which successful embolization was achieved with varying technical approaches, suggesting this technique's versatility and adaptability to different tumor characteristics.ConclusionThe EMBOGUARD™ Balloon Guide Catheter technique represents a promising addition to the endovascular treatment arsenal for CBTs. Continued evaluation through larger case series and longer follow-up periods is essential to fully establish flow arrest's role in CBT management.
背景
颈动脉体瘤（CBTs）是起源于颈动脉体的神经内分泌肿瘤。恶性病例可出现多种并发症。因此，手术切除是首选的治疗方法。然而，术前栓塞是一种既定的辅助治疗方法，尤其是对于较大的有症状肿瘤。目前的去血管化操作包括多种技术和材料，如使用液体或栓塞材料栓塞供血血管、弹簧圈栓塞、直接肿瘤穿刺和覆膜支架置入。在本病例系列中，我们展示了我们使用既定栓塞技术和通过EMBOGUARD球囊导引导管（强生神经血管公司，加利福尼亚州欧文市）对外颈动脉（ECA）进行球囊闭塞的联合方法对CBTs进行预处理的初步经验。
方法
我们对2023年3月至2024年2月的病历进行了回顾性研究，包括18岁以上被诊断为颈动脉体瘤且使用EMBOGUARD球囊导引导管进行术前栓塞的患者。主要观察指标是血管造影去血管化程度。安全结果包括手术并发症，如非靶性栓塞到先前未累及的区域和颅神经缺损。
结果
我们纳入了3例通过不同技术方法成功栓塞的病例，表明该技术具有多功能性且能适应不同肿瘤特征。
结论
EMBOGUARD™球囊导引导管技术是CBTs血管内治疗武器库中一个有前景的补充。通过更大规模的病例系列和更长的随访期进行持续评估对于充分确立血流阻断在CBT管理中的作用至关重要。
