Preoperative Embolization Of Carotid Body Tumours: Yes Or No?

Authors

  • Tiago Soares Department of Angiology and Vascular Surgery, São João Hospital Centre; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal
  • Paulo Dias Department of Angiology and Vascular Surgery, São João Hospital Centre; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal
  • Sérgio Sampaio Department of Angiology and Vascular Surgery, São João Hospital Centre; CINTESIS – Center of Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal
  • José Teixeira Department of Angiology and Vascular Surgery, São João Hospital Centre, Portugal https://orcid.org/0000-0002-3940-4024

DOI:

https://doi.org/10.48729/pjctvs.206

Abstract

Introduction: Carotid body tumours (CBT) are rare paragangliomas for which surgical resection is still the recommended treatment. Frequently they are a benign disorder, discovered as asymptomatic neck masses located at the carotid bifurcation. Preoperative embolization has been used to decrease tumor volume, intraoperative blood loss and nerve injuries.There is however still much controversy and some studies argue that this strategy could increase risks without benefit.

This study aimed to investigate the impact of embolization on CBT resection outcomes.

 

Methods: We analyzed all electronic clinical records on consecutive patients treated in the last 10 years (January 2008 – January 2018) in our vascular surgery department. Patients were divided into 2 groups according to treatment: preoperative embolization and subsequent resection (PE) and resection alone (RA). The following variables were reviewed and compared between groups: age, gender, tumor size, surgery duration, days of hospitalization, complications and transfusion needs.

 

Results: Sixteen tumours were treated. Of these, 6 underwent PE and 10 underwent RA. Median follow-up was 54 months (IQR 78). All tumours were benign and no disease recurrence was detected. When compared, PE and RA groups had no differences in Shamblin classification (p=0.068), although tumor’s median size was significantly bigger in CBT-PE (49mm v. 35,5mm, p=0,016).The days of hospitalization were significantly higher in the PE group (median 7 vs 3 p=0.012).  Concerning surgery time (201min v. 141min, p=0.093), cranial nerve injury (66.7% v. 20%, p=0.092) and need for intraoperative transfusion  (16,7% v. 10%, p=0.625), no differences were found.

 

Conclusions: The role of preoperative embolization in CBT has been questioned.

In this study we found no benefits supporting embolization prior to surgery.

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Published

14-01-2023

How to Cite

1.
Soares T, Dias P, Sampaio S, Teixeira J. Preoperative Embolization Of Carotid Body Tumours: Yes Or No?. Rev Port Cir Cardiotorac Vasc [Internet]. 2023 Jan. 14 [cited 2023 Feb. 3];29(4):27-30. Available from: https://pjctvs.com/index.php/journal/article/view/206

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