Pterygovaginal artery as a target of embolization before endoscopic skull base surgery

Keisuke Yoshida, Takenori Akiyama, Eytan Raz, Dai Kamamoto, Hiroyuki Ozawa, Masahiro Toda

研究成果: Article査読

1 被引用数 (Scopus)

抄録

Background: The pterygovaginal artery (PtVA), a recurrent branch of the internal maxillary artery (IMA), can be a feeder of skull base tumors. Preoperative embolization can help endoscopic resection of hypervascular lesions, which is performed under a narrow surgical space with restricted instrumental maneuverability. Methods: We performed preoperative embolization in five cases with hypervascular skull base lesions supplied by the PtVA, four of which were resected via endoscopic endonasal approach. In two cases, selective PtVA embolization through the distal IMA was successfully conducted. Results: In all the cases, intraoperative bleeding during endoscopic resection was easily controlled. The medial and lateral origins of the PtVA from the IMA were demonstrated by cone-beam CT images reconstructed from three-dimensional rotational angiography, and anastomoses around the eustachian tube and soft palate were visualized by superselective angiography. Conclusions: The PtVA embolization can be an effective strategy before endoscopic skull base tumor resection. When embolizing through the PtVA, clinicians should be aware of its anatomical variations and dangerous anastomoses. Understanding the surrounding angioarchitecture by angiographic techniques helps ensure safe embolization.

本文言語English
ジャーナルNeuroradiology Journal
DOI
出版ステータスAccepted/In press - 2021

ASJC Scopus subject areas

  • 放射線学、核医学およびイメージング
  • 臨床神経学

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