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Abstract：
Background: After two decades from its introduction in the lateral skull base paraganglioma surgery, the indications and results of preoperative internal carotid artery stenting should be critically assessed. Materials and Methods: Monocentric retrospective study on 26 patients affected by head and neck paragangliomas (19 tympanojugular paragangliomas, 4 carotid body paragangliomas, 3 vagal paragangliomas) preoperatively treated with internal carotid artery stents between 2008 and 2023. The preoperative findings, the intraoperative complications and the final surgical results were analyzed. Results: The stent complication rate was less than 3.1%. Self-expanding highly flexible intracranial nitinol stents were applied. In all cases, it was possible to completely mobilize the internal carotid artery and perform a vascular dissection of the tumor. Gross total tumor resection was possible in 85% of cases. The median follow up was 7.83 y (SD +/- 3.93 y). No local recurrence was observed. Conclusions: The preoperative vascular stent facilitates tumor dissection from the internal carotid artery without risk of vascular damage, helping the surgeon to achieve surgical radicality. The vascular stent is indicated in the case of revision surgeries, circumferential involvement of the vessel and in cases with non-insufficient intracerebral crossflow. Procedural complications, temporary antiplatelet therapy and delay of surgery are the limitations of the procedure.
摘要：
背景：在将其引入外侧颅底副神经节瘤手术二十年后，术前应严格评估颈内动脉支架置入术的适应证和结果.材料和方法：对26例受头颈部副神经节瘤影响的患者进行单中心回顾性研究（19例鼓室颈静脉副神经节瘤，4颈动脉体副神经节瘤，3迷走神经节旁瘤）在2008年至2023年之间使用颈内动脉支架进行术前治疗。术前发现，分析术中并发症及最终手术效果。结果:支架并发症发生率低于3.1%。应用自膨式高柔性颅内镍钛诺支架。在所有情况下,完全动员颈内动脉并对肿瘤进行血管解剖是可能的。在85％的病例中，可以进行全部肿瘤切除。中位随访时间为7.83y（SD+/-3.93y）。没有观察到局部复发。结论：术前血管支架有利于颈内动脉肿瘤的解剖，没有血管损伤的风险。帮助外科医生实现外科手术的激进性。在翻修手术的情况下，需要血管支架，血管的圆周受累以及脑内交叉流不足的情况。手术并发症,临时抗血小板治疗和手术延迟是手术的局限性.
