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Neurol Res. 2012 Jul;34(6):523-9. doi: 10.1179/1743132812Y.0000000036. Epub 2012 May 30.

Combined preoperative onyx embolization and protective internal carotid artery covered stent placement for treatment of glomus vagale tumor: review of literature and illustrative case.

Author information

1
Department of Neurosurgery, College of Medicine, Neuropsychiatric Institute, University of Illinois at Chicago, IL, USA. alaraj@uic.edu

Abstract

OBJECTIVE:

Surgical resection of complex glomus vagale tumors can be complicated by extensive blood loss and might require surgical sacrifice of an encased internal carotid artery.

METHODS:

A young patient presented with mass effect from glomus valage tumor. Computerized tomography angiography showed an encased internal carotid artery. Cerebral angiography demonstrated a highly vascular tumor. A literature review was performed for endovascular treatment options for neck tumors.

RESULTS:

Staged preoperative embolization of feeder arteries via internal maxillary artery, and thyrocervical trunk with onyx was performed. A covered stent was implanted in the cervical internal carotid artery to the common carotid artery; this resulted in complete devascularization of the tumor with exclusion of external carotid artery from the circulation. This is followed by surgical resection of the tumor.

CONCLUSION:

Preoperative embolization with onyx decreased the amount of blood loss intra-operatively. The implantation of a covered stent in the cervical internal carotid artery through the common carotid artery contributed for further devasculatization of the tumor bed, as well as provided a lumen continuity in case iatrogenic carotid injury is encountered intra-operatively.

PMID:
22642870
DOI:
10.1179/1743132812Y.0000000036
[Indexed for MEDLINE]

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