Alessandro Pedicelli1, Emilio Lozupone1, Iacopo Valente1, Francesco Snider2,3, Mario Rigante4, Francesco D'Argento1, Andrea Alexandre1, Giuseppe Garignano5, Luigi Chiumarulo6, Gaetano Paludetti4,7, Cesare Colosimo1,5. 1. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC Radiologia e Neuroradiologia, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italia. 2. Dipartimento di Scienze Cardiovascolari e Toraciche, UOC Chirurgia Vascolare, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italia. 3. Istituto di Patologia Speciale Chirurgica, Università Cattolica del Sacro Cuore, Roma, Italia. 4. Dipartimento di Scienze Dell'invecchiamento, Neurologiche, Ortopediche e della Testa-collo, UOC Otorinolaringoiatria, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italia. 5. Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia. 6. UOC Neuroradiologia, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Italia. 7. Istituto di Clinica Otorinolaringoiatrica, Università Cattolica del Sacro Cuore, Roma, Italia.
Abstract
OBJECTIVE: The authors have evaluated their experience in pre-operative direct puncture embolization of hypervascular tumors of the head and neck using SQUID 12, an embolic liquid agent. METHODS: Between July 2016 and March 2019, the authors retrospectively reviewed clinical, embolization and surgical data of 11 consecutive patients with 12 hypervascular head and neck tumors who had undergone pre-operative embolization using SQUID 12. Percutaneous embolizations were performed by inserting a 19-22 Gauge needle directly into the tumor under ultrasound, fluoroscopic and/or endoscopic guidance. The hub of the needle was connected to a 15-cm DMSO-compatible extension tube, and the SQUID 12 was injected. RESULTS: Total or near-total devascularization was achieved in 11 over 12 cases. Complete en-bloc tumor removal by surgery was achieved in all cases. Only one patient required blood transfusion. No major periprocedural adverse events were recorded. CONCLUSIONS: Direct puncture embolization of hypervascular tumors of the head and neck using SQUID 12 seems to be safe and effective. It may offer almost complete devascularization due to homogenous, deep penetration in the tumor, with optimal visibility of the agent throughout the percutaneous procedure. It may reduce intraoperative blood loss and the need for transfusion, thus facilitating complete surgical resection.
OBJECTIVE: The authors have evaluated their experience in pre-operative direct puncture embolization of hypervascular tumors of the head and neck using SQUID 12, an embolic liquid agent. METHODS: Between July 2016 and March 2019, the authors retrospectively reviewed clinical, embolization and surgical data of 11 consecutive patients with 12 hypervascular head and neck tumors who had undergone pre-operative embolization using SQUID 12. Percutaneous embolizations were performed by inserting a 19-22 Gauge needle directly into the tumor under ultrasound, fluoroscopic and/or endoscopic guidance. The hub of the needle was connected to a 15-cm DMSO-compatible extension tube, and the SQUID 12 was injected. RESULTS: Total or near-total devascularization was achieved in 11 over 12 cases. Complete en-bloc tumor removal by surgery was achieved in all cases. Only one patient required blood transfusion. No major periprocedural adverse events were recorded. CONCLUSIONS: Direct puncture embolization of hypervascular tumors of the head and neck using SQUID 12 seems to be safe and effective. It may offer almost complete devascularization due to homogenous, deep penetration in the tumor, with optimal visibility of the agent throughout the percutaneous procedure. It may reduce intraoperative blood loss and the need for transfusion, thus facilitating complete surgical resection.
Entities:
Keywords:
Head and neck; embolization; image-guided procedures; innovative biotechnologies; liquid embolic agents
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