CIO 2022-17 Preoperative Embolization in Carotid Body Tumors: A Single-Center Experience in India

Purpose: The purpose of this study is to compare the efficiency of preoperative embolization on vascular rupture rates during surgery in 260 patients within two groups.

Materials and Methods: Prospective medical records of 140 patients who underwent preoperative tumor embolization and 120 patients who did not undergo embolization were reviewed. All patients underwent surgical resection of a carotid body tumor from January 2014 to January 2022 within a tertiary care hospital. Demographic data, including age, gender, and tumor size, were collected. Glomic artery supply was evaluated with digital subtraction angiography in each patient. The degree of flow reduction was calculated instantly after each injection of embolic material. Complications of embolization were also collected. The estimated blood loss (EBL) and the operation time were obtained from intraoperative records and operative notes dictated at the time of surgery. Operative records were evaluated for carotid artery rupture and Shamblin classification of glomus tumors.

Results: The mean patient age was 48.5 (range, 22–70) years; 60 patients were male, and 200 were female. All of the patients except 20 patients had Shamblin classification II. The mean diameter of tumor size was 4.42 cm. Relative rates of blood flow reduction during embolization were greater than 80% in 80 patients and 75% in 60 patients. Carotid artery injury was recorded in 10 patients within the embolization group and in 20 patients within the other group. There were significant differences between carotid artery rupture and embolization, blood loss, tumor size, and supplying artery.

Conclusions: Transarterial preoperative embolization of carotid body tumors reduces the EBL during surgery, leading to better delineation of the tumor margins, improving the ease of resection, and reducing the operating time and the number blood transfusions without any significant complications.