The earlier, the better: The beneficial effect of different timepoints of the preoperative transarterial embolization on ameliorating operative blood loss and operative time for carotid body tumors

Li, Nan; Zeng, Ni; Yuan, Wei; Wen, Chunyong; Yang, Jun; Li, Jiaping; Dai, Haitao; Liao, Changli; Tang, Keyu; Wang, Jingsong; Chang, Guangqi; Huang, Yonghui

doi:10.1016/j.surg.2021.07.005

Cited by 4 publications

(3 citation statements)

References 20 publications

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“… 9 In addition, studies suggest that as the time between preoperative tumor embolization and excision increases, both the blood loss and the operative time increase. 10 Regarding excision of giant CBTs specifically, using Onyx for preoperative embolization at a 48-hour time point before excision has previously been described with good results. 11 In the present case, we used Onyx 34 because the injection is slow, controlled, and less likely to cause catheter entrapment.…”

Section: Discussionmentioning

confidence: 99%

Five-year outcome of a staged giant Shamblin type III carotid body tumor excision

Dittman,

Ghodke,

Moe

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Discussionmentioning

confidence: 99%

Five-year outcome of a staged giant Shamblin type III carotid body tumor excision

Dittman,

Ghodke,

Moe

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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“… 7 , 8 Timing of pre‐embolization before surgical resection is also important to consider due to the risk of tumor revascularization prior to resection. 9 Other studies found no significant differences in EBL from pre‐embolization. 10 , 11 , 12 Overall, selective pre‐embolization is more commonly performed in Shamblin II/III CBTs that are generally more complex with longer estimated operation times, but ultimately depends on surgeon preference and are recommended to be performed by qualified interventional physicians.…”

Section: Introductionmentioning

confidence: 92%

“…However, embolization presents with risks, including local inflammation, neural damage, and a 3% risk of downstream emboli 7,8 . Timing of pre‐embolization before surgical resection is also important to consider due to the risk of tumor revascularization prior to resection 9 . Other studies found no significant differences in EBL from pre‐embolization 10–12 .…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience

Wong,

Tam,

Tran

et al. 2023

Laryngoscope Investig Oto

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ObjectiveTo evaluate the effects and outcomes of multidisciplinary surgical approaches in the management of carotid body tumors (CBT).MethodsA single‐center retrospective study at the University of California—Los Angeles Medical Center was conducted on patients who presented with CBTs and underwent surgical resections from 1998 to 2020. Statistical analysis was performed using IBM SPSS v27 and Excel.ResultsA total of 75 patients with 79 CBT resections were included. Operating surgical subspecialties included: 41.8% vascular surgery, 24.1% otolaryngology head and neck surgeons (OHNS), and 31.6% combined OHNS and vascular. 68.4% of tumors underwent preoperative embolization. EBL was directly correlated with tumor size. CBT size was similar for OHNS (30 mm) and vascular (31 mm) but was significantly larger for combined OHNS and vascular cases (38 mm). EBL was higher in combined cases (301 mL) compared to OHNS (124 mL) or vascular (203 mL) alone. Incidence of postoperative cranial nerve deficits was 7.8%, with combined OHNS and vascular cases having an incidence of 4.0% when compared to OHNS (5.3%) versus vascular surgery alone (12.1%).ConclusionCBTs can be managed effectively by single surgical specialties with similar outcomes between vascular surgery and OHNS. In larger, higher grade tumors, however, a combined vascular and OHNS approach had lower incidence of postoperative cranial nerve injuries when compared to single specialty resections, despite a larger EBL. Thus, a multidisciplinary surgical approach suggests favorable outcomes with fewer incidence of cranial nerve deficits for larger, more complex CBT resections.Level of Evidence2b—Individual retrospective cohort study.

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Clinical Characteristics and Surgical Outcomes of Carotid Body Tumors: Data from the Carotid Paraganglioma Cooperative International Registry (CAPACITY) Group

González-Urquijo

Viteri-Pérez²,

Becerril-Gaitan

et al. 2022

World j. surg.

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Background This study's objective was to conduct a multinational registry of patients with carotid body tumors (CBTs) and to analyze patients' clinical characteristics, treatments, and outcomes. Methods Retrospective study from the Carotid Paraganglioma Cooperative International Registry involving eleven medical centers in Bolivia, Ecuador, Mexico, and Spain, of all patients with a CBT who underwent resection between 2009 and 2019. Results A total of 1432 patients with a CBT surgically treated were included. Median patient age was 54 years (range: 45-63 years), and 82.9% (1184) of the study cohort were female. While at low altitude, the proportion of female-to-male cases was 2:1, at high altitude, this proportion increased to 8:1, with statistically significant differences (p = .022). Median operative time was 139 min (range: 110-180 min), while median operative blood loss was 250 ml (range: 100-500 ml), with statistically significant difference in increased blood loss (p = .001) and operative time (p = .001) with a higher Shamblin classification. Eight (0.6%) patients suffered stroke. Univariate analysis analyzing for possible factors associated with increased odds of stroke revealed intraoperative vascular lesion to present an OR of 2.37 [CI 95%;] (p = 0.001). In 245 (17.1%), a cranial nerve injury was reported. Seven (0.5%) deaths were recorded. ConclusionThe most common CBT type on this cohort was hyperplasic, which might be partially explained by the high altitudes where these patients lived. Increased blood loss and operative time were associated with a higher Shamblin classification, and the risk of stroke was associated with patients presenting transoperative vascular lesions.

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The earlier, the better: The beneficial effect of different timepoints of the preoperative transarterial embolization on ameliorating operative blood loss and operative time for carotid body tumors

Cited by 4 publications

References 20 publications

Five-year outcome of a staged giant Shamblin type III carotid body tumor excision

Five-year outcome of a staged giant Shamblin type III carotid body tumor excision

Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience

Clinical Characteristics and Surgical Outcomes of Carotid Body Tumors: Data from the Carotid Paraganglioma Cooperative International Registry (CAPACITY) Group

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