Successful devascularization of carotid body tumors by covered stent placement in the external carotid artery

Abstract

Management of highly vascular carotid body tumors can involve pre-operative percutaneous embolization before definitive surgical resection. This step reduces tumor size, reduces operative blood loss, and makes for a less hazardous dissection with the goal of reducing morbidity and mortality. The effectiveness of a recently described technique of interrupting vascular supply via covered stent placement in the external carotid artery is further described in a series of three recent cases. This technique may be useful for large tumors with a primary blood supply from the external carotid since it avoids the intracranial embolic risk of coils used for this purpose.

Carotid Body Tumors: A Review of 25 Years Experience in Diagnosis and Management of 56 Tumors

“…30) An alternative to embolization is the insertion of a covered stent in the external carotid artery. 31) …”

A Comparison Between the Treatments of Functional and Nonfunctional Carotid Body Tumors

“…30 However, thrombosis in the internal carotid artery and cerebral embolization might be induced by preoperative embolization. 1,4,31e34 Therefore, preoperative embolization and radiation therapy were regarded as adjunctive therapies to surgery, 2,3,31,35 and only one patient was subjected to preoperative embolization in group B.…”

Carotid Paraganglioma in Adolescence-Clinical Picture-Surgical Technique and Review of the Literature

“…Other authors suggest that PAE could have a potential role in Shamblin III lesions and tumors involving the carotid arteries [30]. Alternatively, a proximal covered stent can be placed in the external carotid artery preventing intracranial emboli from coils during PAE [31]. In the same session, balloon occlusion of the internal carotid artery can be performed to determine if the patient can tolerate blockage of the vessel in case of ligation, clamping, or shunting [23].…”