Balloon guide catheter use for carotid body tumor embolization: A retrospective case series

BackgroundCarotid body tumors (CBTs) are neuroendocrine tumors that arise from the carotid body. The malignant cases can present with a multitude of complications. Thus, surgical resection is the preferred treatment of choice. However, preoperative embolization is an established adjuvant treatment, especially with larger and symptomatic tumors. Current devascularization practice includes numerous techniques and materials, such as using liquid or embolic materials to embolize feeding vessels, coil embolization, direct tumor puncture, and covered stent placement. In this case series, we present our initial experience in pre-treatment of CBTs using a combined approach of established embolization techniques and balloon occlusion of the external carotid artery (ECA) via the EMBOGUARD^™ Balloon Guide Catheter (Johnson & Johnson Neurovascular, Irvine, CA).MethodsWe performed a retrospective review of medical records from March 2023 to February 2024, including patients over 18 years old diagnosed with a carotid body tumor who had pre-operative embolization using the EMBOGUARD^™ Balloon Guide Catheter. The primary outcome measure was the degree of angiographic devascularization achieved. Safety outcomes included procedural complications, such as non-target embolization into previously uninvolved territories and cranial nerve deficits.ResultsWe included three cases in which successful embolization was achieved with varying technical approaches, suggesting this technique's versatility and adaptability to different tumor characteristics.ConclusionThe EMBOGUARD™ Balloon Guide Catheter technique represents a promising addition to the endovascular treatment arsenal for CBTs. Continued evaluation through larger case series and longer follow-up periods is essential to fully establish flow arrest's role in CBT management.