Intracranial head and neck tumors: endovascular considerations, present and future

To review the literature on endovascular therapies available to clinicians to aid in the management of head, neck, and intracranial tumors. Hypervascular tumors of the head and neck region, as well as the intracranial region, are associated with large amounts of blood loss intraoperatively. Preoperative embolization of selected hypervascular tumors has been proposed in the literature as a method of reducing blood loss intraoperatively. This technique involves superselective catheterization of the feeding arteries to the tumor bed and then by infusion of embolic particles to saturate the tumor bed in the hopes of inducing necrosis. For less vascular tumors, selective infusion of chemotherapeutic agents has been reported as a method of reducing the systemic toxic effects of these medications. Endovascular therapies for hypervascular and less vascular tumors hold promise, although multicenter randomized controlled trials are required to help identify the patients that will benefit the most.