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Russian Neurosurgical Journal named after Professor A. L. Polenov

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Endovascular superselective chemoembolization in a personalized approach to the treatment of patients with hypervascularized tumors of the head and neck complicated by nasal bleeding

Abstract

This work is devoted to the analysis of the possibilities of a new technique (personalized endovascular superselective chemoembolization) in the treatment of patients with locally advanced forms of locally advanced forms of malignant neoplasms of the head and neck complicated by nosebleed. Based on the literature data, as well as our own clinical observations, conclusions have been drawn about the effectiveness of personalized endovascular superselective chemoembolization of malignant neoplasms of the head and neck complicated by nosebleeds in stopping and preventing these bleeds in the future.

FORPOZE OF THE STUDY: to increase the effectiveness of diagnosis and treatment of patients with locally advanced malignant endovascular hypervascularized tumors of the head and neck complicated by nosebleeds based on the introduction into clinical practice of a new technique — endovascular superselective chemoembolization of these neoplasms.

MATERIALS AND METHODS: to solve this problem, 93 cases of patients with locally advanced malignant hypervascularized tumors of the head and neck, complicated by nosebleeds, were studied on the basis of the introduction into clinical practice of a new technique — endovascular superselective chemoembolization of malignant hypervascularized tumors of the head and neck.

RESULTS. In 93 cases, endovascular superselective angiography and endovascular superselective chemoembolization of malignant neoplasms of the head and neck complicated by nosebleeds were performed. The embolization was a mixture of microparticles of hepaSphere 50–100 microns saturated with cytostatic — doxorubicin (50 mg). The main sources of recurrent nosebleeds were the following basins of the external carotid artery: in 46.2 % of cases, the basin (hereinafter referred to as «b») of the maxillary artery, in 37.6 % — b. ascending pharyngeal artery, in 8.6 % — occipital artery, in 5.4 % — carotid node, in 2.2 % — mixed pools of blood supply to the tumor (from the pools of the external carotid artery and internal carotid artery on one side or on both sides). The hemostatic effect was achieved in all 93 patients due to sequential endovascular superselective chemoembolization of the vascular bed of the tumor itself, and in the future nosebleeds did not occur in these patients.

CONCLUSION. The personalized method of endovascular superselective chemoembolization with doxyrubicin of tumors with locally widespread forms of malignant neoplasms of the head and neck complicated by nosebleeds developed and implemented in medical practice was the initial stage of the combined method of treatment of this disease. A good hemostatic effect was achieved in all 93 patients.

About the Authors

S. D. Radzhabov
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation

Radzhabov Saidakhmed Dzhabrailovich

St. Petersburg



V. G. Voronov
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation

Voronov Viktor Grigor`evich

St. Petersburg



A. A. Ivanov
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation

Ivanov Arkady Aleksandrovich

St. Petersburg



Z. M. Rasulov
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation

Rasulov Zaur Makhachevich

St. Petersburg



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Review

For citations:


Radzhabov S.D., Voronov V.G., Ivanov A.A., Rasulov Z.M. Endovascular superselective chemoembolization in a personalized approach to the treatment of patients with hypervascularized tumors of the head and neck complicated by nasal bleeding. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(2):122-127. (In Russ.)

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ISSN 2071-2693 (Print)