Selective Embolization Combined with Intraoperative Internal Carotid Artery Shunt for Surgical Treatment of The Type Ⅲ Carotid Body Tumor_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SHI Sen ¹ , YANG Hui ¹ , ZHOU Xiangyu ¹ , SONG Li ² ,  HE Yanzheng. ¹

1.Deparment of Vascular Surgery， The Affiliated Hospital of Luzhou Medical College， Luhzou 646000， Sichuan Province， China;;
2.Department of Anesthesiology， The Affiliated Hospital of Luzhou Medical College， Luhzou 646000， Sichuan Province， China;

Corresponding author：

HE Yanzheng., Email: heyanzheng@163.com

Keywords：

Carotid body tumor; Super selective embolization; Intraoperative internal carotid artery shunt

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Objective 　To investigate the experience of selective embolization combined with intraoperative internal carotid artery shunt for surgical treatment of carotid body tumor （CBT）.
Methods 　The data of 21 patients （22 sides） with CBT who underwent surgical resection from January 2002 to July 2012 in our hospital were retrospectively reviewed. The all patients’ conditions were fully assessmented and all patients were performed the carotid arteriography and superselective embolization treatment for the blood supply of tumor by with microcatheter on 2-3 days before operation，and then intraoperative internal carotid artery shunt and resection of carotid body tumors were performed.
Results 　Surgical procedures were successfully performeded in all 21 patients （22 sides）. Among them， 16 patients （17 sides） were taken carotid body tumor resected， 5 patients were taken carotid body tumor resected and internal carotid artery reconstruction （autogenous long saphenous vein were used in 3 patients， vascular prosthesis were used in 2 patients）. The postoperative complications were found in 5 patients after anesthesia recovery， which included crooked tongue in 3 cases and facial numbness in 2 cases， and they were cured in 3 months. There were no cerebral infarction， hemiplegia， and death cases. All 21 patients were followed-up for a period from 2 months to 9 years（average 57 months）， there was no tumor recurred.
Conclusions 　Surgical resection is the first choice for treatment of carotid body tumor. The application of selective embolization and intraoperative internal carotid artery shunt for surgical treatment of carotid body tumor in complicated Shamblin Ⅲ stage is safe and effective.

Citation： SHI Sen,YANG Hui,ZHOU Xiangyu,SONG Li,HE Yanzheng.. Selective Embolization Combined with Intraoperative Internal Carotid Artery Shunt for Surgical Treatment of The Type Ⅲ Carotid Body Tumor. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(10): 1088-1091. doi: Copy

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2.	Shamblin WR， ReMine WH， Sheps SG， et al. Carotid body tumor(chemodectoma). Clinocopathological analysis of ninety cases[J].Am J Surg， 1971， 122(6)：732-739.
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6.	胡绍童，皮厚山，华道亮，等. 颈动脉体瘤CT和DSA的影像学表现对比研究[J]. 中国临床医学影像杂志， 2010， 21(4)：271-273.
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11.	Lim JY， Kim J， Kim SH， et al. Surgical treatment of carotid body paragangliomas：outcomes and complications according to the shambling classification[J]. Clin Exp Otorhinolaryngol， 2010， 3(2)： 9l-95.
12.	胡敏，张立海，杨舸，等. 选择性血管栓塞术辅助颈动脉体瘤切除术[J]. 华西口腔医学杂志， 2010， 28(4)： 387-390.
13.	Sahin MA， Jahollari A， Guler A， et al. Results of combined preo-perative direct percutaneous embolization and surgical excision in treatment of carotid body tumors[J]. Vasa， 2011， 40（6）：461-466.
14.	Power AH， Bower TC， Kasperbauer J et al. Impact of preopera-tive embolization on outcomes of carotid body tumor resections[J]. J Vasc Surg， 2012， 56(4)：979-989.
15.	赵纪春，马玉奎，黄斌，等. 术中颈内动脉转流在颈动脉体瘤切除中的作用[J]. 中华普通外科杂志， 2010， 25(7)：533-535.
16.	杨斌，张承磊. 颈动脉体瘤外科治疗安全性探讨(附39例病例分析)[J]. 昆明医学院学报， 2010， 31(3)：54-58.
17.	章希炜，杨宏宇，孙蓬，等. 颈动脉内膜剥脱术治疗动脉粥样硬化性颈内动脉闭塞症[J]. 中华普通外科杂志， 2006， 21(10)： 727-728.
18.	Sunar H， Keles C， Besirli K. Elective shunt use for easy resectionof a carotid body tumor[J]. Vascular， 2008， 16(1)： 41-43.
19.	李然，卢向阳，杨震，等. 包裹型颈动脉体瘤手术严重并发症救治[J]. 口腔医学， 2013， 33(2)：119-121.
20.	Vogel TR， Mousa AY， Dombrovskiy VY， et al. Carotid bodytumor surgery：management and outcomes in the nation[J]. VascEndovasc Surg， 2009， 43(5)：457-461.
21.	陈建华，徐健，马文锋，等. 颈动脉体瘤的诊断与手术治疗[J].中国普外基础与临床杂志， 2010， 17(4)：385-386.
22.	Knight TT Jr， Ganzalez JA， Rary JM， et a1. Current concepts for the surgical management of carotid body tumor[J]. Am J Surg， 2006， 191(1)： 104-110.
23.	Hendrikse J， Hartkamp MJ， Hillen B， et al. Collateral ability of the circle of Willis in patients with unilateral internal carotid artery occlusion：border zone infarcts and clinical symptoms[J]. Stroke， 2001， 32(12)：2768-2773.
24.	王玉琦，陈斌，符伟国，等. 颈动脉体瘤的手术并发症[J]. 中华普通外科杂志， 2005， 20(9)： 549-551.
25.	周翔宇，杨辉，钟武，等. 颈动脉体瘤15例的外科诊治体会[J]. 临床外科杂志， 2011， 19(3)： 176-178.

1. Georgiadis GS， Lazarides MK， Tsalkidis A， et al. Carotid body tumor in a 13-year-old child：Case report and review of the literature[J]. J Vasc Surg， 2008， 47(4)：874-880.
2. Shamblin WR， ReMine WH， Sheps SG， et al. Carotid body tumor(chemodectoma). Clinocopathological analysis of ninety cases[J].Am J Surg， 1971， 122(6)：732-739.
3. 金毕，赖传善，乐格芬，等. 颈动脉体瘤的诊断和治疗(附26例报告)[J]. 中国普外基础与临床杂志， 1999， 6(1)：36-37.
4. Sajid MS， Hamilton G， Baker DM， et al. A multicenter review of carotid body tumor management[J]. Eur J Vasc Endovasc Surg， 2007， 34(2)： 127-130.
5. Luna-Ortiz K， Rageon-Ortiz M， Villavicencio-Valencia V， et al. Carotid body tumor： review of a 20-year experience[J]. Oral Oncol， 2005， 41(1)： 56-61.
6. 胡绍童，皮厚山，华道亮，等. 颈动脉体瘤CT和DSA的影像学表现对比研究[J]. 中国临床医学影像杂志， 2010， 21(4)：271-273.
7. Kuwada C， Mannion K， Aulino JM， et al. Imaging of the carotidspace[J]. Otolaryngol Clin North Am， 2012， 45(6) ： 1273-1292.
8. 张德智，马天璇，李丹，等. 颈动脉体瘤的CT、MRI诊断[J]. 临床放射学杂志， 2008， 27(4)：452-454.
9. Li J， Wang S， Zee C， et al. Preoperative angiography and transa-rterial embolization in the management of carotid body tumor：a single-center， 10-year experience[J]. Neurosurgery， 2010， 67 (4)：941-948.
10. Zeitler DM， Glick J， Har-El G. Preoperative efflbolization in carotid body tumor sugery：is it required?[J]. Ann Otol Bhinol Laryngol， 2010， 119(5)：279-283.
11. Lim JY， Kim J， Kim SH， et al. Surgical treatment of carotid body paragangliomas：outcomes and complications according to the shambling classification[J]. Clin Exp Otorhinolaryngol， 2010， 3(2)： 9l-95.
12. 胡敏，张立海，杨舸，等. 选择性血管栓塞术辅助颈动脉体瘤切除术[J]. 华西口腔医学杂志， 2010， 28(4)： 387-390.
13. Sahin MA， Jahollari A， Guler A， et al. Results of combined preo-perative direct percutaneous embolization and surgical excision in treatment of carotid body tumors[J]. Vasa， 2011， 40（6）：461-466.
14. Power AH， Bower TC， Kasperbauer J et al. Impact of preopera-tive embolization on outcomes of carotid body tumor resections[J]. J Vasc Surg， 2012， 56(4)：979-989.
15. 赵纪春，马玉奎，黄斌，等. 术中颈内动脉转流在颈动脉体瘤切除中的作用[J]. 中华普通外科杂志， 2010， 25(7)：533-535.
16. 杨斌，张承磊. 颈动脉体瘤外科治疗安全性探讨(附39例病例分析)[J]. 昆明医学院学报， 2010， 31(3)：54-58.
17. 章希炜，杨宏宇，孙蓬，等. 颈动脉内膜剥脱术治疗动脉粥样硬化性颈内动脉闭塞症[J]. 中华普通外科杂志， 2006， 21(10)： 727-728.
18. Sunar H， Keles C， Besirli K. Elective shunt use for easy resectionof a carotid body tumor[J]. Vascular， 2008， 16(1)： 41-43.
19. 李然，卢向阳，杨震，等. 包裹型颈动脉体瘤手术严重并发症救治[J]. 口腔医学， 2013， 33(2)：119-121.
20. Vogel TR， Mousa AY， Dombrovskiy VY， et al. Carotid bodytumor surgery：management and outcomes in the nation[J]. VascEndovasc Surg， 2009， 43(5)：457-461.
21. 陈建华，徐健，马文锋，等. 颈动脉体瘤的诊断与手术治疗[J].中国普外基础与临床杂志， 2010， 17(4)：385-386.
22. Knight TT Jr， Ganzalez JA， Rary JM， et a1. Current concepts for the surgical management of carotid body tumor[J]. Am J Surg， 2006， 191(1)： 104-110.
23. Hendrikse J， Hartkamp MJ， Hillen B， et al. Collateral ability of the circle of Willis in patients with unilateral internal carotid artery occlusion：border zone infarcts and clinical symptoms[J]. Stroke， 2001， 32(12)：2768-2773.
24. 王玉琦，陈斌，符伟国，等. 颈动脉体瘤的手术并发症[J]. 中华普通外科杂志， 2005， 20(9)： 549-551.
25. 周翔宇，杨辉，钟武，等. 颈动脉体瘤15例的外科诊治体会[J]. 临床外科杂志， 2011， 19(3)： 176-178.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Selective Embolization Combined with Intraoperative Internal Carotid Artery Shunt for Surgical Treatment of The Type Ⅲ Carotid Body Tumor

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