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Preoperative Transarterial Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma Using n-Butyl Cyanoacrylate: Case-Control Comparison with Microspheres
Institution:1. Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China;2. Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China;1. Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin;2. Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin;3. Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania;4. Division of Vascular and Interventional Radiology, Department of Radiology, University of California San Diego, La Jolla, California;1. St George’s University School of Medicine, Grenada, West Indies;2. Prostate Centers USA, Falls Church, VA;1. Larner College of Medicine at the University of Vermont, University of Vermont, Burlington, Vermont;2. University of Vermont Medical Center, Burlington, Vermont;1. Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts;2. Medical School, Sigmund Freud University, Vienna, Austria;3. Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts;4. Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
Abstract:PurposeTo evaluate the efficacy and safety of transarterial embolization (TAE) with n-butyl cyanoacrylate (nBCA) for juvenile nasopharyngeal angiofibroma (JNA).Materials and MethodsA retrospective review was performed on patients with JNA who underwent TAE and endoscopic resection between 2020 and 2022. Patients embolized with nBCA were identified, and those embolized with microspheres were set as the control group. Data on demographics, symptoms, tumor characteristics, blood loss, adverse events, residual disease, and recurrence were collected, and case-control analysis was performed for the 2 groups. Differences in characteristics between the groups were tested using the Fisher exact and Wilcoxon tests. A generalized linear model (GLM) was used to analyze the univariate and multivariate influences on blood loss.ResultsTwenty patients were included in this study: 13 in the microsphere group and 7 in the nBCA group. The median blood loss was 400 mL (interquartile range IQR], 200–520 mL) in the nBCA group and 1,000 mL (IQR, 500–1,000 mL) in the microsphere group (P = .028). The GLM confirmed lower blood loss in the nBCA group (relative risk, 0.58 0.41–0.83]; P = .01). A residual tumor was found in 1 patient in each group (7.7% vs 14.3%; P = 1.000). Recurrence was not observed in any patient. None of the patients experienced adverse events during embolization.ConclusionsTAE of advanced JNA with nBCA glue is safe and effective and can significantly reduce intraoperative blood loss compared with microspheres.
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