[Combined endovascular and surgical management of carotid paraganglioma]

Surgical intervention is the only method of radical treatment of carotid paraganglioma (CP). Intraoperative blood loss may exceed 2 litters. Ligation of the external carotid artery (ECA) is not always possible technically due to tumour invasion to the ECA's walls. Prior to operation, in order to diminish blood loss it is suggested to perform endovascular embolization (EE) of the vessels feeding the tumour. The case report presented herein concerns an 18-year-old male patient with CP after comprehensive diagnosis including ultrasonographic duplex scanning with Doppler colour mapping, enhanced-contrast spiral computed tomography, selective carotid angiography. The patient was subjected to selective. EE of the afferent vessels of CP. Embolization of the branch of the ascending pharyngeal artery travelling to the lower pole of the tumour, and that of the large branches feeding the upper pole of the tumour from the initial portion of the occipital artery with poly vinyl alcohol (PVA-300) and hydrogel "Embox" was followed by surgical intervention: removal of the tumour, closure of the ostia of the tumour's own arteries, ligation of the EC A. The volume of intraoperative blood loss amounted to 350 ml. The postoperative period proved uneventful with nothing to report. During the check-up examinations of the patient, performed 3, 6, 12 and 24 months after the operation, a good postoperative therapeutic outcome was noted to persist.