Preoperative embolization of highly vascular head and Neck Tumors and its impact on surgical outcome: A single-center experience

Abstract

Objective: To evaluate how pre-operative trans-arterial embolization (TAE) affects the surgical outcomes of patient undergoing excision of vascular head and neck tumors.

Methodology: This retrospective observational study was conducted at Department of Neuroendovascular Surgery, Punjab Institute of Neurosciences, Lahore, Pakistan from February 2024 to January 2025. It is a non-probability based consecutive case series, including 16 patients in accordance with the inclusion criteria.

Results: Out of the 16 Patients enrolled in the study, 14 were male and 2 females with a mean age of 19.7±7.71 Years (Range; 14-37 Years). Except two patients with meningioma, all of the patients had JNA. The mean time between surgical excision and embolization was 38.6±18.9 hours, with most operations performed within 24–48 hours. Devascularization was graded as good in 12 patients (75%), fair in 2 (12.5%), and poor in 2 (12.5%). Mean operative times were 4.3 hours for good, 5.0 hours for fair, and 6.0 hours for poor devascularization. Corresponding ICU stays were 30, 48, and 72 hours, while ward stays averaged 2.2, 2.5, and 3.0 days, respectively. Better devascularization correlated with shorter surgery duration, reduced ICU time, and earlier discharge.

Conclusion: Preoperative TAE is effective for highly vascular head and neck tumors, enabling shorter surgeries, easier debulking, and reduced blood loss. Polyvinyl alcohol (PVA) particles provide clear tumor margins and satisfactory devascularization.