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A comparison of particulate and Onyx embolization in preoperative devascularization of carotid body tumors

  • Interventional Neuroradiology
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Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgments

J.J.B., N.C., and A.S.P. received grant support from ev3, Irvine, CA, USA, and Microvention, Tustin, CA, USA, to study the mechanisms of aneurysm healing.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, University of Michigan, Ann Arbor, MI, USA

    Julius Griauzde

  2. Division of NeuroInterventional Radiology, Department of Radiology, University of Michigan Health System, UH B1D 328, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA

    Joseph J. Gemmete, Neeraj Chaudhary & Aditya S. Pandey

  3. Department of Neurosurgery, University of Michigan Health System, Ann Arbor, MI, USA

    Joseph J. Gemmete, Neeraj Chaudhary, Aditya S. Pandey, Steven E. Sullivan, Erin L. McKean & Lawerence J. Marentette

  4. Cranial Base Surgery Program, Department of Otolaryngology, University of Michigan Health System, Ann Arbor, MI, USA

    Joseph J. Gemmete, Steven E. Sullivan, Erin L. McKean & Lawerence J. Marentette

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  1. Julius Griauzde
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  2. Joseph J. Gemmete
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Correspondence to Joseph J. Gemmete.

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Griauzde, J., Gemmete, J.J., Chaudhary, N. et al. A comparison of particulate and Onyx embolization in preoperative devascularization of carotid body tumors. Neuroradiology 55, 1113–1118 (2013). https://doi.org/10.1007/s00234-013-1220-3

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  • DOI: https://doi.org/10.1007/s00234-013-1220-3

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