Preoperative embolization of brain, head, and neck tumors: Single center experience and literature review.

Abstract

Objective: The management of highly vascularized tumors in the brain, head, and neck regions poses significant challenges. This review aims to provide practical insights into using preoperative embolization to improve surgical outcomes and guide healthcare centers with limited expertise in this technique.

Methods: A literature review was conducted using PubMed, Scopus, and Web of Science databases with keywords related to preoperative embolization and highly vascularized tumors, detailing its definition, indications, diagnostic considerations, procedural aspects, clinical and surgical implications, and associated complications. The findings are supported by data from 309 patients with brain, head, and neck tumors treated with preoperative embolization at Hospital Clínica Kennedy in Guayaquil, Ecuador, from 2015 to 2023. Cases without embolization or those below the clavicular border were excluded. Illustrations and photographs, based on the authors' surgical experience, are included with informed consent.

Results: Preoperative embolization has proven effective in reducing morbidity, enhancing surgical outcomes, and palliating symptoms in inoperable cases by decreasing tumor size. While complications are rare, they can be minimized with careful planning. Despite its efficacy, the lack of randomized controlled trials due to the rarity of hypervascular tumors limits the ability to establish standardized practices.

Conclusions: Preoperative embolization is a valuable tool in managing highly vascularized tumors. However, further research and uniform reporting are essential to optimize outcomes and develop clear guidelines for this critical procedure.