J NeuroIntervent Surg 4:251-255 doi:10.1136/neurintsurg-2012-010350
  • Standards

Head, neck, and brain tumor embolization guidelines

Open Access
  1. Sandra Narayanan14 on behalf of the Society for Neurointerventional Surgery
  1. 1Department of Neurosurgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA
  2. 2Department of Radiology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA
  3. 3Department of Neurology and Neurosciences, New Jersey Medical School, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA
  4. 4Neurosurgery, Radiology, Pediatrics and Biomedical Engineering, University of Cincinnati, Mayfield Clinic and Cincinnati Children's Hospital, Cincinnati, OH, USA
  5. 5Barrow Neurosurgical Associates, LTD, Phoenix, AZ, USA
  6. 6Director of Neuroendovascular and Skull Base Surgery, Yale Department of Neurosurgery, New Haven, CT, USA
  7. 7Mallinckrodt Institute of Radiology and Washington University School of Medicine/Barnes Jewish Hospital, St. Louis, MO, USA
  8. 8Department of Neurological Surgery University of Kentucky, Lexington, KY, USA
  9. 9Massachusetts General Hospital, Boston, MA, USA
  10. 10Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
  11. 11Department of Radiology, Stanford University Medical Center, Stanford, CA, USA
  12. 12Warren Alpert School of Medicine at Brown University, Rhode Island Hospital, Providence, RI, USA
  13. 13Radiology and Neurological Surgery, Columbia University, College of Physicians & Surgeons and Neuroendovascular Service New York Presbyterian-Columbia, Neurological Institute of New York, NY, USA
  14. 14Deptartments of Neurosurgery and Neurology, Wayne State University School of Medicine, Detroit, MI, USA
  1. Correspondence to Dr Chirag D Gandhi, Neurological Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 90 Bergen St, Suite 8100, Newark, NJ 07103, USA; gandhich{at}
  1. Contributors JD and CDG contributed significantly to the writing of the manuscript and CJP had important input into the final editing of the manuscript. Significant contributions were also made by the members of the Standards of Practice Committee.

  • Accepted 9 March 2012
  • Published Online First 26 April 2012


Background Management of vascular tumors of the head, neck, and brain is often complex and requires a multidisciplinary approach. Peri-operative embolization of vascular tumors may help to reduce intra-operative bleeding and operative times and have thus become an integral part of the management of these tumors. Advances in catheter and non-catheter based techniques in conjunction with the growing field of neurointerventional surgery is likely to expand the number of peri-operative embolizations performed. The goal of this article is to provide consensus reporting standards and guidelines for embolization treatment of vascular head, neck, and brain tumors.

Summary This article was produced by a writing group comprised of members of the Society of Neurointerventional Surgery. A computerized literature search using the National Library of Medicine database (Pubmed) was conducted for relevant articles published between 1 January 1990 and 31 December 2010. The article summarizes the effectiveness and safety of peri-operative vascular tumor embolization. In addition, this document provides consensus definitions and reporting standards as well as guidelines not intended to represent the standard of care, but rather to provide uniformity in subsequent trials and studies involving embolization of vascular head and neck as well as brain tumors.

Conclusions Peri-operative embolization of vascular head, neck, and brain tumors is an effective and safe adjuvant to surgical resection. Major complications reported in the literature are rare when these procedures are performed by operators with appropriate training and knowledge of the relevant vascular and surgical anatomy. These standards may help to standardize reporting and publication in future studies.



  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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