Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle
Abstract Background Removal of large hypervascular tumors in the lateral ventricle still poses a surgical challenge. These tumors are usually fed from choroidal arteries, and vascular control is typically performed late during the removal. We aimed to evaluate the clinical efficacy of our strategy f...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-021-02129-4 |
| _version_ | 1818959271601111040 |
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| author | Yukihiro Yamao Kazumichi Yoshida Akira Ishii Masahiro Tanji Masakazu Okawa Yohei Mineharu Takayuki Kikuchi Yoshiki Arakawa Hiroharu Kataoka Yasushi Takagi Susumu Miyamoto |
| author_facet | Yukihiro Yamao Kazumichi Yoshida Akira Ishii Masahiro Tanji Masakazu Okawa Yohei Mineharu Takayuki Kikuchi Yoshiki Arakawa Hiroharu Kataoka Yasushi Takagi Susumu Miyamoto |
| author_sort | Yukihiro Yamao |
| collection | DOAJ |
| description | Abstract Background Removal of large hypervascular tumors in the lateral ventricle still poses a surgical challenge. These tumors are usually fed from choroidal arteries, and vascular control is typically performed late during the removal. We aimed to evaluate the clinical efficacy of our strategy for persistent preoperative obliteration of feeders from the choroidal arteries to manage large hypervascular tumors in the lateral ventricle. Methods We retrospectively analyzed six patients with hypervascular tumors in the lateral ventricle. We first attempted to obstruct feeders using endovascular treatment, and, if unavailable, performed initial microsurgical occlusion through the temporal horn for the staged tumor removal. Results In all patients, feeder obliteration was successfully performed; the anterior choroidal arteries were occluded by the endovascular treatment and microsurgical occlusion in one and five patients, respectively, while the lateral posterior choroidal arteries were occluded via endovascular treatment in four patients. No patients had permanent symptoms due to feeder obliteration, and tumor devascularization was achieved at the mean rate of 69.9%. During the tumor removal, the mean blood loss volume was 253 ml. No postoperative hemorrhage had occurred, and all patients scored ≤ 2 on the modified Rankin Scale at six months post-removal. Conclusions Although further studies are warranted, persistent feeder obliteration of choroidal arteries could be an effective treatment strategy against large hypervascular tumors in the lateral ventricle. |
| first_indexed | 2024-12-20T11:38:59Z |
| format | Article |
| id | doaj.art-19d51ca24276445a92f80c0512a025ab |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-20T11:38:59Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-19d51ca24276445a92f80c0512a025ab2022-12-21T19:42:02ZengBMCBMC Neurology1471-23772021-03-012111810.1186/s12883-021-02129-4Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricleYukihiro Yamao0Kazumichi Yoshida1Akira Ishii2Masahiro Tanji3Masakazu Okawa4Yohei Mineharu5Takayuki Kikuchi6Yoshiki Arakawa7Hiroharu Kataoka8Yasushi Takagi9Susumu Miyamoto10Department of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Tokushima UniversityDepartment of Neurosurgery, Kyoto University Graduate School of MedicineAbstract Background Removal of large hypervascular tumors in the lateral ventricle still poses a surgical challenge. These tumors are usually fed from choroidal arteries, and vascular control is typically performed late during the removal. We aimed to evaluate the clinical efficacy of our strategy for persistent preoperative obliteration of feeders from the choroidal arteries to manage large hypervascular tumors in the lateral ventricle. Methods We retrospectively analyzed six patients with hypervascular tumors in the lateral ventricle. We first attempted to obstruct feeders using endovascular treatment, and, if unavailable, performed initial microsurgical occlusion through the temporal horn for the staged tumor removal. Results In all patients, feeder obliteration was successfully performed; the anterior choroidal arteries were occluded by the endovascular treatment and microsurgical occlusion in one and five patients, respectively, while the lateral posterior choroidal arteries were occluded via endovascular treatment in four patients. No patients had permanent symptoms due to feeder obliteration, and tumor devascularization was achieved at the mean rate of 69.9%. During the tumor removal, the mean blood loss volume was 253 ml. No postoperative hemorrhage had occurred, and all patients scored ≤ 2 on the modified Rankin Scale at six months post-removal. Conclusions Although further studies are warranted, persistent feeder obliteration of choroidal arteries could be an effective treatment strategy against large hypervascular tumors in the lateral ventricle.https://doi.org/10.1186/s12883-021-02129-4Hypervascular tumorEmbolizationFeeder obliterationLateral ventricleChoroidal artery |
| spellingShingle | Yukihiro Yamao Kazumichi Yoshida Akira Ishii Masahiro Tanji Masakazu Okawa Yohei Mineharu Takayuki Kikuchi Yoshiki Arakawa Hiroharu Kataoka Yasushi Takagi Susumu Miyamoto Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle BMC Neurology Hypervascular tumor Embolization Feeder obliteration Lateral ventricle Choroidal artery |
| title | Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle |
| title_full | Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle |
| title_fullStr | Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle |
| title_full_unstemmed | Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle |
| title_short | Preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle |
| title_sort | preoperative obliteration of choroidal arteries in the treatment of large hypervascular tumors in the lateral ventricle |
| topic | Hypervascular tumor Embolization Feeder obliteration Lateral ventricle Choroidal artery |
| url | https://doi.org/10.1186/s12883-021-02129-4 |
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