Simultaneous removal of carotid paraganglioma and carotid endarterectomy (case report)
AbstractCarotid paragangliomas are rare disease. Radical removal of the tumor is the method of choice in the treatment such patients. The risks of surgical treatment are potential injury of the branches of the cranial nerves of the caudal group and the possible reconstruction of the carotid arteries. The combination of a tumor process with an atherosclerotic lesion of the carotid artery bifurcation is extremely rare. Single cases of both simultaneous and staged removal of the tumor and reconstruction of the carotid bifurcation due to atherosclerotic lesions are observed.
We present a unique clinical case of simultaneous open surgical treatment of a patient with a large carotid chemodectoma type I according to the Shamblin classification and hemodynamically significant atherosclerotic stenosis of the ipsilateral internal carotid artery. Accumulated experience in treating patients with paragangliomas of the neck, as well as atherosclerotic lesions of the brachiocephalic arteries, allowed us to choose the optimal tactics of surgical treatment and achieve acceptable results.
Keywords:carotid chemodectoma; atherosclerotic lesion of carotid artery; carotid endarterectomy; tumor excision; simultaneous surgery
Funding. The study had no financial support.
Conflict of interest. The authors declare no conflicts of interest.
Authors’ contribution. Study conception and design – Chupin A.V., Kutovaya A.S.; data collection and handling – Kutovaya A.S.; draft manuscript preparation – Golovyuk A.L., Kutovaya A.S., Verdikhanov N.I.; manuscript revision – Chupin A.V., Golovyuk A.L.
For citation: Chupin A.V., Golovyuk A.L., Kutovaya A.S., Verdikhanov N.I. Simultaneous removal of carotid paraganglioma and carotid endarterectomy (case report). Angiology and Vascular Surgery. Journal named Academician A.V. Pokrovsky. 2022; 28 (3): 98–102. DOI: https://doi.org/10.33029/1027-6661-2022-28-3-98-102 (in Russian)
References
1. Clinical angiology: Manual/Ed. by A.V. Pokrovsky. 2 V. V 2. Moscow: Medicine. 2004; 888. (in Russian)
2. Kakkos S.K., Reddy D.J., Shepard A.D., et al. Contemporary presentation and evolution of management of neck paragangliomas. Journal of Vascular Surgery. 2009; 49 (6): 1365–1373. DOI: https://doi.org/10.1016/j.jvs.2009.01.059
3. Sajid M.S., Hamilton G., Baker D.M. A Multicenter Review of Carotid Body Tumour Management. European Journal of Vascular and Endovascular Surgery. 2007; 34 (2): 127–130. DOI: https://doi.org/10.1016/j.ejvs.2007.01.015
4. Мatyakin E.G., Dan V.N., Shybin А.А., et al. Paragangliomas of the neck (chemodectomas). Moscow: Verdana. 2005; 240. (in Russian)
5. Robertson V., Poli F., Hobson B., et al. A Systematic Review and Meta-Analysis of the Presentation and Surgical Management of Patients With Carotid Body Tumours. European Journal of Vascular and Endovascular Surgery. 2019; 57 (4): 477–486. DOI: https://doi.org/10.1016/j.ejvs.2018.10.038
6. Hinojosa C.A., Anaya-Ayala J.E., Laparra-Escareno H., et al. Concomitant Surgical Treatment of Symptomatic Carotid Artery Disease With a Coexisting Shamblin I Carotid Body Tumor. Vascular and Endovascular Surgery. 2017; 51 (2): 103–107. DOI: https://doi.org/10.1177/1538574416689430
7. Fokin A.A., Degtyarev M.S., Borsuk D.A. Simultaneous treatment of carotid paraganglioma and stenosis of the carotid arteries. Angiology and Vascular Surgery. 2014; 20 (3): 145–147. (in Russian)
8. Smeds M., Jacobs D. Symptomatic carotid stenosis in the setting of bilateral disease and coexisting carotid body tumor: management with a carotid stent and staged excision. Vascular. 2013; 21 (6): 396–199. DOI: https://doi.org/10.1177/1708538112472286
9. Maxwell J.G., Jones S.W., Wilson E., et al. Carotid body tumor excisions: adverse outcomes of adding carotid endarterectomy. Journal of the American College of Surgeons. 2004; 198 (1): 36–41. DOI: https://doi.org/10.1016/j.jamcollsurg.2003.08.024