Pierre De Marini1, Michel Greget2, Emanuele Boatta3, Christine Jahn4, Iulian Enescu5, Julien Garnon6, Danoob Dalili7, Roberto Luigi Cazzato8, Afshin Gangi9. 1. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: pierre.demarini@chru-strasbourg.fr. 2. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: michel.greget@chru-strasbourg.fr. 3. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: emanuele.boatta@chru-strasbourg.fr. 4. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: christine.jahn@chru-strasbourg.fr. 5. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: iulian.enescu@chru-strasbourg.fr. 6. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: julien.garnon@chru-strasbourg.fr. 7. Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Oxford OX3 7LD, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK. Electronic address: ddalili@gmail.com. 8. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: roberto-luigi.cazzato@chru-strasbourg.fr. 9. Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France. Electronic address: afshin.gangi@chru-strasbourg.fr.
Abstract
OBJECTIVES: To retrospectively evaluate the safety and technical success of pre-operative embolization (POE) of head and neck paragangliomas (HNP) in a single-center cohort over a 10-year period, and to benchmark our results with those derived from a systematic analysis of the available literature. METHODS: All consecutive HNP embolized between November 2010 and April 2020 were included and reviewed. In total, there were 27 HNP in 27 patients [8 (30%) males; 19 (70%) females; mean age 53 ± 16 years; range 30-86]. Embolization technique, total procedure time, dose area product (DAP), complications, rate of HNP devascularization, and technical success (i.e. ≥80% devascularization of the HNP) were recorded and analyzed. A systematic analysis on the safety and technical success of POE was then conducted according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Twenty-one (21/27; 78%) HNP were treated with an endovascular approach and 6/27 (22%) with a percutaneous or combined (endovascular/percutaneous) technique. Mean total procedure time and DAP were 108 ± 48 min (range 45-235) and 92.5 ± 61.3 Gy·cm2 (range 19.9-276.0), respectively. Two (2/27; 7%) complications (one minor, one major) were observed. Mean HNP devascularization was 88 ± 15% (range 23-100) with technical success achieved in 24/27 (89%) HNP. Literature analysis revealed a pooled rate of complication and technical success of 3.8% (95% CI: 0.5-8.8%) and 79.0% (95% CI: 63.6-91.6%), respectively. CONCLUSIONS: POE of HNP is safe and results in extensive devascularization in the majority of treated tumors.
OBJECTIVES: To retrospectively evaluate the safety and technical success of pre-operative embolization (POE) of head and neck paragangliomas (HNP) in a single-center cohort over a 10-year period, and to benchmark our results with those derived from a systematic analysis of the available literature. METHODS: All consecutive HNP embolized between November 2010 and April 2020 were included and reviewed. In total, there were 27 HNP in 27 patients [8 (30%) males; 19 (70%) females; mean age 53 ± 16 years; range 30-86]. Embolization technique, total procedure time, dose area product (DAP), complications, rate of HNP devascularization, and technical success (i.e. ≥80% devascularization of the HNP) were recorded and analyzed. A systematic analysis on the safety and technical success of POE was then conducted according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Twenty-one (21/27; 78%) HNP were treated with an endovascular approach and 6/27 (22%) with a percutaneous or combined (endovascular/percutaneous) technique. Mean total procedure time and DAP were 108 ± 48 min (range 45-235) and 92.5 ± 61.3 Gy·cm2 (range 19.9-276.0), respectively. Two (2/27; 7%) complications (one minor, one major) were observed. Mean HNP devascularization was 88 ± 15% (range 23-100) with technical success achieved in 24/27 (89%) HNP. Literature analysis revealed a pooled rate of complication and technical success of 3.8% (95% CI: 0.5-8.8%) and 79.0% (95% CI: 63.6-91.6%), respectively. CONCLUSIONS: POE of HNP is safe and results in extensive devascularization in the majority of treated tumors.
Authors: Mauricio Gonzalez-Urquijo; Victor Hugo Viteri-Pérez; Andrea Becerril-Gaitan; David Hinojosa-Gonzalez; María Elizabeth Enríquez-Vega; Ivan Walter Soto Vaca Guzmán; Gregorio Eloy Valda-Ameller; José de Jesús García-Pérez; Carlos Vaquero-Puerta; Victor Hugo Jaramillo-Vergara; Miguel Angel Cisneros-Tinoco; Joaquin Miguel Santoscoy-Ibarra; Mario Alejandro Fabiani Journal: World J Surg Date: 2022-07-24 Impact factor: 3.282