“Extarterectomy” for Tumors Invading the Carotid Artery: An Animal Model

Kazım Öner; Cem Bilgen; Ismail Oran; Tayfun Kirazli; Ahmet Memiş; Izzet Övül; Özlem Yilmaz

doi:10.1055/s-2007-984485

Skull Base, Table of Contents

Skull Base 2007; 17(4): 229-234
DOI: 10.1055/s-2007-984485

ORIGINAL ARTICLE

“Extarterectomy” for Tumors Invading the Carotid Artery: An Animal Model

Kazım Öner¹ , Cem Bilgen² , Ismail Oran³ , Tayfun Kirazli² , Ahmet Memiş³ , Izzet Övül¹ , Özlem Yilmaz⁴

¹Department of Neurosurgery, Ege University, School of Medicine, Izmir, Turkey
²Department of Otorhinolaryngology, Ege University, School of Medicine, Izmir, Turkey
³Department of Radiology, Ege University, School of Medicine, Izmir, Turkey
⁴Department of Histology, Ege University, School of Medicine, Izmir, Turkey

Abstract

ABSTRACT

Objective: Carotid artery (CA) invasion by head and neck tumors is a challenging problem for the cranial base surgeon. Proposed methods for management have the disadvantage of constant or temporary interruption of the arterial blood flow and, as a consequence, cerebral ischemic complications. The objective of the study was to investigate the long-term effects of a novel technique, “extarterectomy,” on the vascular wall and the arterial blood flow in an ovine model. Methods: Wallstents were implanted bilaterally in the common CA of 5 sheep by the Seldinger technique. Six weeks after stent implantation, a segment of the arterial wall of about 2 cm in length was peeled off the external surface of the stent. Six months later, control angiography was performed. The animals were sacrificed after 18 months and the “extarterectomized” arteries were removed for the microscopic and macroscopic evaluation. Results: There were no acquired neurological deficits in the study group. Extarterectomy was performed without any complication in every case. Control angiography confirmed patent CAs. Evaluation by light microscopy showed the “neointimal” layer within the interstices of the stent. Conclusion: Extarterectomy allows aggressive tumor removal together with the maintenance of blood flow through the CA and offers hope for those with tumors invading the CA.

KEYWORDS

Carotid artery - head and neck cancer - carotid stenting

Full Text

References

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Cem BilgenM.D.

Talatpasa Bulv. No 35-5

35220 Alsancak, Izmir, Turkey

Email: cembilgen@gmail.com