Endovascular embolization of highly vascular head and neck tumors

Abstract

ObjectivesEndovascular embolization of hyper vascular head and neck tumors is performed as a palliative measure and in order to reduce blood loss. We report the procedure and results of head and neck tumors embolized via trans-arterial route showing the safety and positive impact of our approach as well as contrasting various embolic agents and their results. MethodsWe collected data of all head and neck tumors embolized at our institution during a nineteen-month period from August 2016 to May 2018. Embolization procedure was conducted 3–7 days before surgery to allow for necrosis. Bilateral angiogram was performed, followed by super selective catheterization of feeding vessel. Particle size was decided according the lumen of the vessel, for smaller vessels we used smaller particles (45–150 μ) and increased particle size up to (150–250 μ) as we moved to larger vessels. ResultsA total of thirty-six patients who underwent the pre-operative and palliative embolization procedure were examined. All embolizations were completed in a single session. No procedure related clinical or technical complications were observed. Intra-operative blood loss was between 200 and 600 ml which is far lower as compared to surgery alone. Total devascularization was achieved in all cases by complete occlusion of supplying arterial feeders. ConclusionPre-surgical embolization is an adjunct therapy that radically improves the surgical outcomes in patients. We found complete excision can easily be achieved using this adjunct therapy which is almost never the case when using surgery alone. Secondly, we found that in patients who could not be operated on embolization was a highly effective palliative measure that gives great symptomatic relief.