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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Embolization of skull-base hypervascular tumors: description of a series of cases and proposal of a therapeutic
Rafael Almeida Péreza1, Héctor Espinosa-García, Gabriel Alcalá-Cerra
1Sección de Neurocirugia, Universidad de Cartagena, Cartagena de Indias, Colombia.
Unlabelled:
Preoperative embolization allows reducing intraoperative blood loss caused by hypervascular intracranial tumors and its undesirable consequences.
Aim:
To describe the experience with preoperative endovascular embolization of hypervascular skull base tumors, and to develop a therapeutic algorithm.
Materials And Methods:
A retrospective examination of preoperative neuroimaging and results of preoperative embolization was carried out.
Results:
Fifteen cases were identified, with a median age of 36 years old, most of them harboring meningiomas, nasopharyngeal angiofibromas or paragangliomas. The external carotid artery was involved in 93% of cases and was the only afferent to 60%. In 27%, there were branches from the internal and external carotid arteries simultaneously. An extensive or complete occlusion grade was achieved in 95% of the branches of the external carotid artery. No branch of the internal carotid artery was treated, because poor contribution to tumor irrigation or was not possible to catheterize the pedicle. There were not recorded procedure-related complications.
Conclusion:
Based on the unification of the experiences described in this study and using data from published series, we present an algorithm for rational selection of skull base tumors that can benefit from preoperative embolization.
