{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:17:09Z","timestamp":1793042229921,"version":"4.5.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The study aims to analyze our first experience with direct percutaneous embolization of carotid body tumors (CBTs) using ethylene-vinyl alcohol copolymer (Onyx) along with balloon test occlusion (BTO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective preliminary single-center study was conducted at the Otorhinolaryngology and Head and Neck Surgery Department and the Medical Imaging Department of the University Teaching Hospital. A consecutive series of three patients with CBTs was treated at the local institution between October 2018 and June 2019. All three patients underwent preoperative percutaneous embolization using ethylene-vinyl alcohol copolymer (Onyx 18) with the addition of BTO. Outcome measures were the percentage of tumor devascularization, intraoperative blood losses, and operation times. BTO was evaluated by clinical neurological examination and neurosonological transcranial Doppler examination of the middle cerebral artery (MCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Devascularization of all three tumors was complete or near complete. All three tumors were surgically extirpated with excellent surgical outcomes. The blood losses were minimal, and the average operation time was 2\u2009h and 8\u2009min. BTO was positive in one patient, which was valuable additional information on carotid branches ligation limitations. The other two patients showed negative BTOs with the result of safety of eventual carotid arteries ligations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative direct percutaneous embolization of CBT with Onyx is a highly effective procedure that significantly facilitates surgery. BTO provides valuable additional information on the most appropriate and safe surgical approach.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1132100","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T05:22:31Z","timestamp":1681449751000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Preoperative percutaneous Onyx embolization of carotid body paragangliomas with balloon test occlusion"],"prefix":"10.3389","volume":"14","author":[{"given":"Martina","family":"Kelblov\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u0159\u00ed","family":"Van\u00ed\u010dek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u0159etislav","family":"G\u00e1l","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Rottenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bulik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Cimflov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1\u0161","family":"K\u0159ivka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.nic.2015.12.005","article-title":"Paragangliomas of the head and neck","volume":"26","author":"Woolen","year":"2016","journal-title":"Neuroimaging Clin N Am"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1177\/0194599815627667","article-title":"Head and neck Paragangliomas: an update on evaluation and management","volume":"154","author":"Moore","year":"2016","journal-title":"Otolaryngol Neck Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1007\/s00117-019-00605-0","article-title":"Diagnosis and treatment of glomus tumors of the skull base and neck","volume":"59","author":"Reith","year":"2019","journal-title":"Radiologe"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1177\/1708538116657504","article-title":"Surgical management of carotid body tumor is Shamblin classification sufficient to predict surgical outcome?","volume":"25","author":"Law","year":"2017","journal-title":"Vascular"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1177\/0194599815605323","article-title":"The effects of preoperative embolization on carotid body Paraganglioma surgery: a systematic review and meta-analysis","volume":"153","author":"Jackson","year":"2015","journal-title":"Otolaryngol--Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg"},{"key":"ref6","first-page":"459","article-title":"Arterial catheter embolization followed by surgery for large chemodectoma","volume":"87","author":"Schick","year":"1980","journal-title":"Surgery"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.ijsu.2018.04.032","article-title":"Impact of preoperative transarterial embolization of carotid body tumor: a single center retrospective cohort experience","volume":"54","author":"Zhang","year":"2018","journal-title":"Int J Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1007\/s00270-010-9803-4","article-title":"Devascularization of head and neck Paragangliomas by direct percutaneous embolization","volume":"33","author":"Ozyer","year":"2010","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.jcma.2011.01.018","article-title":"Preoperative embolization of carotid body tumor by direct percutaneous intratumoral injection of N-butyl cyanoacrylate glue assisted with balloon protection technique","volume":"74","author":"Yang","year":"2011","journal-title":"J Chin Med Assoc"},{"key":"ref10","first-page":"1457","article-title":"Intratumoral injection of cyanoacrylate glue in head and neck Paragangliomas","volume":"25","author":"Abud","year":"2004","journal-title":"Am J Neuroradiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1594","DOI":"10.3174\/ajnr.A1601","article-title":"Percutaneous embolization of carotid Paragangliomas using solely onyx","volume":"30","author":"Wanke","year":"2009","journal-title":"Am J Neuroradiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1016\/j.wneu.2011.02.033","article-title":"Preoperative onyx embolization of vascular head and neck tumors by direct puncture","volume":"77","author":"Elhammady","year":"2012","journal-title":"World Neurosurg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1136\/jnis.2010.003970","article-title":"Preliminary experience with the percutaneous embolization of paragangliomas at the carotid bifurcation using only ethylene vinyl alcohol copolymer (EVOH) onyx","volume":"4","author":"Shah","year":"2012","journal-title":"J NeuroInterventional Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"33","DOI":"10.26676\/jevtm.v4i1.114","article-title":"Glue or onyx: a guide to choice \u2013 tips and techniques","volume":"4","author":"Ierardi","year":"2020","journal-title":"J Endovasc Resusc Trauma Manag"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.nec.2009.01.004","article-title":"Intracranial endovascular balloon test occlusion\u2014indications, methods, and predictive value","volume":"20","author":"Chaudhary","year":"2009","journal-title":"Neurosurg Clin N Am"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"619","DOI":"10.4329\/wjr.v6.i8.619","article-title":"Balloon test occlusion of internal carotid artery: angiographic findings predictive of results","volume":"6","author":"Kikuchi","year":"2014","journal-title":"World J Radiol"},{"key":"ref17","first-page":"4","article-title":"Predictive Value of Angiographic Testing for Tolerance to Therapeutic Occlusion of the Carotid Artery","volume":"26","author":"van Rooij","year":"2005","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1132100\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T05:22:34Z","timestamp":1681449754000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1132100\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,14]]},"references-count":17,"alternative-id":["10.3389\/fneur.2023.1132100"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1132100","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,14]]},"article-number":"1132100"}}