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E-016 pre-operative percutaneous embolization of head and neck tumors
  1. H Zacharatos1,
  2. D Sandhu2,
  3. A Grande3,
  4. B Jagadeesan4,
  5. R Tummala3
  1. 1Department of Neurology, University of Minnesota, Minneapolis, MN, USA
  2. 2Department, University of Minnesota, Minneapolis, MN, USA
  3. 3Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA
  4. 4Department of Radiology, University of Minnesota, Minneapolis, MN, USA

Abstract

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.

Abstract E-016 Table 1

Results

Disclosures H. Zacharatos: None. D. Sandhu: None. A. Grande: None. B. Jagadeesan: None. R. Tummala: None.

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