Combined transarterial and transvenous embolisation of jugulotympanic paragangliomas

Paragangliomas of the jugular region present a greater challenge to the surgeon than paragangliomas in other locations. Because of the vascular nature of the tumour, bleeding can be substantial not only from arterial inflow to the tumour, but also from venous bleeding, if not embolised prior to surgery. Six patients were treated with combined transarterial and transvenous embolisation followed by surgical resection. In each instance, the diagnosis of jugulotympanic paraganglioma was suspected based on MR features. Substantial reduction in loss of blood appears to result from the combined transarterial and transvenous embolisation approach.