incredible-marketing Arrow

Treatment / Preoperative Embolization and Transarterial Chemoembolization

Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck.

Cancers of the head and neck are further categorized by the area of the head or neck in which they begin. These areas are listed below:

  • Oral Cavity
  • Pharynx (throat)
  • Larynx (voice box)
  • Paranasal Sinuses and Nasal Cavity
  • Salivary Glands

Some head and neck tumors are located close to major blood vessels such as the carotid artery. In those cases, it becomes more complicated to plan a safe surgery to remove the tumor. Balloon occlusion testing enables us to see if we can safely close off an artery prior to surgery. Closing off the artery will shut off the blood flow during surgery, avoiding hemorrhage. However, closing off the artery can also cause stroke.

At IVC, we use balloon occlusion testing to determine whether other arteries supplying blood to the brain can take over if we close a particular artery. We start by performing an angiogram, an x-ray that uses contrast dye to highlight certain parts of the body. Next, we inflate a balloon inside the vessel, temporarily blocking its blood flow. This helps us see whether the other arteries are able to compensate for the blocked artery so we can plan the safest most effective intervention.

Treatment Options

At IVC, we offer two minimally invasive catheter-directed treatments for head and neck tumors:

Endovascular Embolization

Endovascular surgery has emerged as an important tool in the treatment of a variety of hypervascular head, neck, and spinal tumors. Although the concept and first use of tumor embolization date back several decades, recent improvements in catheter design, enhanced angiographic imaging capabilities, and development of novel embolic agents have all combined to make endovascular intervention safer, easier, and thus more commonly used in the management of selected tumors. Embolization can be used in select cases as a primary therapy to reduce tumor-related pain, prevent tumor progression, or stop acute tumor-related hemorrhage.

During the procedure your neuro interventionalist will access your femoral artery, and using image guidance will navigate a catheter to the target vessel leading to the tumor. Embolic agents will be used stop the blood supply to the tumor. All agents essentially perform the same task but have slightly different properties and are used for different benefits.

  • NBCA or Onyx are polymer agents that consolidate overtime and have similar properties to conventional superglues that are pushed through a catheter flowing forward from the catheter tip into vessels just short of the tumor itself. When forward flow stops they form a dense plug stopping blood supply to the tumor.
  • Microspheres are tiny polyvinyl alcohol spheres or particles suspended in a sterile solution that are pushed through a catheter flowing forward from the catheter tip into vessels just short of the tumor. As they flow forward the vessel narrows and the particles lodge within the vessel forming a dam. As more particles are deployed a dense plug forms and blood flow stops.
  • Microcoils are tiny coils made from platinum or platinum like alloys that are pushed through a catheter with a special pusher rod. The coil deploys at the tip of the catheter and initially forms a mesh within the vessel being treated. More coils can then be deployed into the mesh. As coils are deployed the mesh structure reduces blood flow and when enough mesh is present, blood flow stops.

Transarterial Chemoembolization

In this treatment, chemotherapy particles are administered directly to the site of the tumor through arteries that supply it. The procedure is minimally invasive and is performed by navigating a catheter through the blood stream into the vessels providing blood flow to the tumor, thereby directly delivering chemotherapy to the tumors.

Transarterial chemotherapy exposes the tumor to high concentrations of chemotherapeutic agents because they are not taken away by the blood stream. At the same time the chemo agent is being delivered the blood supply to the tumor is being deprived, which can result in damage or death of the tumor cells.

Recovery

Most patients experience some side effects after embolization. Pain is the most common and can be controlled by medication. Mild headache may follow any intracranial embolization.

Most patients leave the hospital within 24 hours of the procedure, but those who have considerable pain may need to stay longer. You should be able to resume your normal activities within a week. Until then, mild activity is recommended.

After embolization procedures, follow-up angiography demonstrates the extent of tumor devascularization or tumor reduction. Routine post angiography care includes groin and distal pulse checks and frequent neurologic examinations to detect any clinical deterioration, which may be secondary to ischemia, hemorrhage, or postembolization tumor swelling.

 

If you have been diagnosed with cancer in the head or neck and are exploring your options for treatment, call IVC today at 503-612-0498 to schedule an appointment for consultation.

What Our Patients Are Saying

Read More