Introduction and purpose Prior to surgical resection of a head and neck tumor, cerebral angiography clarifies the tumor’s vascular supply allowing the surgeon to better plan for the surgery. Excessive bleeding intra-operatively can lead to poor visualization of the tumor leading to subtotal resection, surgical complications, usage of blood products, prolonged surgical times and hemodynamic instability. Intra-arterial embolization of a tumor’s vascular supply has been used pre-operatively as an adjunctive treatment to reduce intra-operative bleeding. In cases where there is not a clear intra-arterial approach to the tumor’s vascular supply, percutaneous embolization is a pre-operative treatment that can effectively reduce the tumor’s vascular supply.
Methods and materials A retrospective analysis at two academic institutions, between 2011 and 2015 was performed of patients with head and neck tumors that had pre-operative cerebral angiography with the intention to have tumor embolization. The following information was collected based on the pre-surgical cerebral angiogram: patients’ age, gender, tumor type/location, tumor’s vascular supply, fluoroscopy time, method of embolization (percutaneous, intra-arterial, and/or both modalities), percent embolization, type of embolic agent used, intra-procedure and/or immediate peri-procedural complications and sedation used [general endotracheal anesthesia (GETA) versus conscious sedation (CS)]. Intra-operative blood loss and need for any blood products, immediate and peri-procedural complications and final pathology was collected from the operative and pathology reports.
Results A total of 17 patients were identified, 14 (82%) were male (average age ± SD, 36 ± 22). GETA and CS were used in 13 (76%) and 4(24%) respectively. There was a case of scalp necrosis, which healed following plastic surgery intervention; but otherwise there were no surgical or embolization related complications.
Conclusion Direct, percutaneous embolization of a head and neck tumor is a safe and effective modality that can be a primary treatment or to complement an intra-arterial embolization.
Disclosures H. Zacharatos: None. D. Sandhu: None. A. Grande: None. B. Jagadeesan: None. R. Tummala: None.
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