Home >> Neurological Research, Volume 34, Number 6

Combined preoperative onyx embolization and protective internal carotid artery covered stent placement for treatment of glomus vagale tumor: review of literature and illustrative case

Authors: Alaraj, Ali; Pytynia, Kristen; Carlson, Andrew P; Krishna, P Hari; Charbel, Fady T; Amin-Hanjani, Sepideh; Aletich, Victor

Source: Neurological Research, Volume 34, Number 6, July 2012 , pp. 523-529(7)

Publisher: Maney Publishing

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Abstract:

Objective: Surgical resection of complex glomus vagale tumors can be complicated by extensive blood loss and might require surgical sacrifice of an encased internal carotid artery.

Methods: A young patient presented with mass effect from glomus valage tumor. Computerized tomography angiography showed an encased internal carotid artery. Cerebral angiography demonstrated a highly vascular tumor. A literature review was performed for endovascular treatment options for neck tumors.

Results: Staged preoperative embolization of feeder arteries via internal maxillary artery, and thyrocervical trunk with onyx was performed. A covered stent was implanted in the cervical internal carotid artery to the common carotid artery; this resulted in complete devascularization of the tumor with exclusion of external carotid artery from the circulation. This is followed by surgical resection of the tumor.

Conclusion: Preoperative embolization with onyx decreased the amount of blood loss intra-operatively. The implantation of a covered stent in the cervical internal carotid artery through the common carotid artery contributed for further devasculatization of the tumor bed, as well as provided a lumen continuity in case iatrogenic carotid injury is encountered intra-operatively.

Keywords: Onyx; Covered stent; Glomus tumor; paraganglioma; Preoperative embolization

Document Type: Research Article

DOI: http://dx.doi.org/10.1179/1743132812Y.0000000036

Affiliations: University of Illinois at Chicago, IL, USA

Publication date: 2012-07-01

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