Tumors that are very vascular (have many blood vessels) are often difficult or dangerous to remove surgically, and patients with these tumors require a multidisciplinary team of specialists for treatment. Prior to surgery, endovascular embolization of the tumor, performed by a team of endovascular specialists, can shrink the tumor and decrease its blood supply.
Pre-operative endovascular embolization permits the surgeon to perform a safer and more successful surgical excision of the tumor. In some cases, even when there is no possibility for the tumor to be removed, endovascular embolization can be successful in reducing pain or other symptoms caused by the tumor.
Infusion therapy, a new endovascular technique in which cancer-fighting medication (chemotherapy) is delivered directly to the site of the tumor, has the benefit of decreasing the side effects of chemotherapy while delivering a higher dose of chemotherapy to the tumor. Physicians in the Cerebrovascular Center are on the leading edge of infusion therapy for the treatment of tumors. Our physicians have published in highly respected journals the evidence of their ability to dramatically reduce bleeding during certain tumor surgeries and improve outcomes.
Brain Tumors, Spinal Tumors, and Head/Neck Tumors
If you have a head or neck tumor, your doctor may perform an angiogram to identify the blood vessels that feed your tumor. Your doctor then can access those blood vessels by catheter and close them off. This allows for a safer surgical excision of the tumor by minimizing the blood loss that may otherwise occur.
Some head and neck tumors are located close to major blood vessels. In those cases, our physicians use techniques that can provide the information we need to plan the safest possible surgery to remove your tumor. These techniques include minimally invasive balloon occlusion testing and embolization.
Balloon Occlusion Testing
Balloon occlusion testing enables us to determine whether we can safely close off an artery in anticipation of surgery. We often perform balloon occlusion testing when the tumor surrounds an artery, such as the carotid artery. Closing off the artery will shut off the blood flow during surgery, avoiding hemorrhage. However, closing off the artery can also cause stroke.
We use balloon occlusion testing to determine whether other arteries supplying blood to the brain can take over if we close a particular artery. During an angiogram, we inflate a balloon inside the vessel, temporarily blocking its blood flow. We then see whether the other arteries are able to compensate for the blocked artery. At the same time, we monitor your brain function to ensure there is no neurological decline. Information from the balloon occlusion test helps your surgeon plan the safest surgery for you.
Some tumors are fed by a network of blood vessels. Surgery on these tumors can be made safer by identifying these feeder vessels. We may be able to close these feeder vessels in order to prevent bleeding in advance of surgery. To close (embolize) a vessel, your doctor will thread his or her way up to the targeted blood vessel using a catheter. Your doctor will use the catheter to deliver coils, balloons, stents, or “glues” to close up the vessel. Our physicians are well known for their expertise in these procedures and have published in highly respected journals the evidence of their ability to dramatically reduce bleeding during certain tumor surgeries and improve outcomes.
Klingenstein Clinical Center, 1-North
1450 Madison Avenue
New York, NY 10029