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Impact of Preoperative Embolization on Carotid Body Tumor Surgery

Published:March 02, 2022DOI:https://doi.org/10.1016/j.avsg.2022.01.033

      Highlights

      • There is no consensus on preoperative CBTE.
      • CBTE has no effect directly on neurological and vascular complications.
      • CBTE significantly reduces the amount of intraoperative bleeding.

      Background

      The aim of this study is to investigate the effect of preoperative carotid body tumor embolization (CBTE) on the amount of bleeding, and vascular and neurological complications in carotid body tumors.

      Methods

      Fifty patients treated for 51 carotid body tumors in 2 clinics, between 2005 and 2020, were evaluated. Polyvinyl alcohol embolization of the carotid body tumor was performed in 23 patients before the surgical excision. The results were compared with the remaining 28 patients, in whom CBTE was not performed, in terms of neurological complications, requirement of additional vascular interventions, bleeding amount, and length of hospital stay.

      Results

      Mean bleeding amount was significantly lower in the CBTE group (406–217 mL, P < 0.05). Median erythrocyte suspension transfusion was significantly lower in the CBTE group (0.3 units vs. 1.1 units, P < 0.05). Neurological deficits developed in a total of 13 patients: 6 in the CBTE group and 7 in the non-CBTE group, in the early postoperative period (P = 0.90). No significant difference was observed between the groups in terms of additional vascular interventions and length of hospital stay (P = 0.79 and P = 0.61).

      Conclusions

      Carotid body tumors are rarely encountered tumors. However, their surgical excision is challenging for surgeons regarding intraoperative and postoperative bleeding. This study demonstrates that preoperative CBTE significantly reduces the amount of bleeding, especially in Shamblin type II/III tumors.
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