Superselective Embolization and Surgery of Noninvoluting Hemangiomas and A-V Malformations

ABSTRACT Background/objectives Laryngeal paragangliomas are benign slow growing tumors with symptoms resembling squamous cell carcinoma. Hoarseness or dysphasia is the commonest presenting symptom and usually it presents as a submucosal mass on laryngoscopy. A total of 90% of these tumors occur in the supraglottic larynx and the rest in the glottis and the subglottic region. Functional activity is seen in a few (2.9%), none are associated with paraneoplastic syndromes. Setting Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru. Case report A 35-year-old male presented to us with hoarseness of voice since 4 months duration. Contrast arteriography demonstrated that the left superior thyroid artery supplied greater than 80% of the blood supply to the laryngeal mass. Superselective embolization was done from the right femoral under local anesthesia and sedation which was uneventful. Intervention The tumor was excised from lateral pharyngotomy approach with an elective tracheostomy. Microscopy suggested it to be paraganglioma and immunohistochemistry confirmed it. Conclusion Complete surgical resection or partial laryngectomy with meticulous dissection of surrounding tissues and preservation of neurovascular structures give an excellent prognosis as far as oncological clearance is concerned. Malignant paragangliomas of the larynx are rare and a major meta-analysis is necessary to provide a true biological behavior of this tumor. How to cite this article Naik SM. Supraglottic Laryngeal Paraganglioma: A Rare Clinical Entity managed by Lateral Pharyngotomy Approach. Int J Phonosurg Laryngol 2012;2(2): 69-73.

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Patients with Life-Threatening Arterial Renal Hemorrhage: CT Angiography and Catheter Angiography with Subsequent Superselective Embolization

CardioVascular and Interventional Radiology ◽

10.1007/s00270-009-9787-0 ◽

2010 ◽

Vol 33 (3) ◽

pp. 498-508 ◽

Cited By ~ 19

Author(s):

C. M. Sommer ◽

U. Stampfl ◽

N. Bellemann ◽

S. Ramsauer ◽

B. M. Loenard ◽

...

Keyword(s):

Ct Angiography ◽

Catheter Angiography ◽

Renal Hemorrhage ◽

Superselective Embolization ◽

Life Threatening

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Superselective Embolization of Arterial Bleeding as a Late Complication 3 Months After Nephron Sparing Surgery for Renal Cell Carcinoma

The Scientific World JOURNAL ◽

10.1100/tsw.2004.88 ◽

2004 ◽

Vol 4 ◽

pp. 350-352

Author(s):

J. Thomas ◽

F.G.E. Perabo ◽

R. Bachmann ◽

G. Steiner ◽

H. Schild ◽

...

Keyword(s):

Renal Cell ◽

Late Complication ◽

Cell Cancer ◽

Invasive Procedure ◽

Nephron Sparing Surgery ◽

First Case ◽

Arterial Bleeding ◽

Nephron Sparing ◽

Superselective Embolization ◽

Arterial Branch

To our knowledge, this is the first case of an arterial bleeding as a late complication 3 months after nephron sparing surgery of renal cell cancer, presumably originating from an arteriocalyceal fistula. Superselective embolization of the feeding arterial branch was chosen for treatment of the hemorrhage and proved successful. The high efficacy of superselective embolization as a minimally invasive procedure in this and other cases of bleeding Vessels should be the preferred method instead of open surgery.

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Superselective Embolization with Microcoil and Gelfoam for High-Flow Priapism Secondary to Bilateral Cavernous Fistulae: A Case Study

Case Reports in Urology ◽

10.1155/2019/3916056 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Sarah Prattley ◽

Timothy Bryant ◽

Rowland Rees

Keyword(s):

Erectile Function ◽

High Flow ◽

Intracavernosal Injection ◽

Arteriovenous Fistulas ◽

First Case ◽

Ct Angiogram ◽

Superselective Embolization ◽

Long Term Follow Up

Background. High-flow priapism is rare, and bilateral arteriocavernous fistulae formation following trauma is rarer still. Management of high-flow priapism is conservative either through observation, use of ice packs, mechanical decompression, or intracavernosal injection of α-adrenergic agonists, giving temporary results in selected cases. Alternatively, superselective arteriography with embolization is widely accepted. However, intervention needs to be mindful of the potential impact on long-term potency. We report the first case of bilateral arteriocavernous fistulae managed with both Gelfoam and microcoil embolization. Case Study. We present the case of a 35-year-old gentleman who attended the emergency department nine days following a fall from a moped, where he sustained bruising to his perineum, with persistent nonpainful erection. CT angiogram demonstrated bilateral arteriovenous fistulas. Management with superselective catheterisation and embolization with Gelfoam and microcoil was successful with resolution of symptoms. Long-term follow-up has shown return to normal erectile function twelve months following the injury. Outcomes. Concern regarding the effect to long-term erectile function has previously led to delayed bilateral embolization. Selection of embolization material can be tailored to the anatomical features of the fistula to help preserve function.

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