Super-Selective Intra-arterial Embolization of Hypervascular Head and Neck Tumors

The management of vascular head and neck tumors is often challenging and may require a multidisciplinary treatment approach. Endovascular embolization is a widespread practice in use for many years, and our team has extensive experience using this procedure with a variety of tumors. Embolization is often utilized in combination with surgical techniques for a variety of different tumor types to minimize morbidity and improve chances for successful tumor resection. The beneficial effect of intra-arterial embolization is a reduction in blood flow to tumors. Pre-operative embolization is known to (1) decrease bleeding during tumor resection; (2) lessen time in surgery; and (3) contribute to tumor shrinkage or slowed growth in areas that have been embolized. Lipiodol has been approved for decades as a radio-opaque contrast agent. Its use for embolization has typically been in combination with chemotherapy at the same time (e.g., cisplatin) in a process called chemoembolysis. Despite the widespread use and acceptance of embolization and chemoembolization, there is little objectively determined scientific data about the surgical, radiographic, and pathologic benefits from pre-operative lipiodol embolization. Advances in technique and embolization materials as well as the availability of experienced interventionalists has greatly increased the number of preoperative embolization procedures performed. In this proposal we present a protocol to gather objective, detailed measurements about the impact of embolization with lipiodol including specific surgical, radiographic, and pathologic metrics that have not previously been systematically reported for this patient population. In so doing, we build the sound scientific basis to proceed with future intra-arterial treatments for our patients.

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