Tumors Identified via Selective Catheterization of the External Carotid Artery

1. Juvenile nasopharyngeal angiofibroma:

• young boys presenting with epistaxis 
• vascular hamartoma
• embolization is therapeutic

2. Carotid body paraganglioma:

• found at the bifurcation of the carotid artery where they splay its internal and external branches
• prolonged, intense tumor blush
• resectability depends on angle between ICA and ECA
• patients often left with hoarseness due to proximity of vagus nerve
• preoperative embolization may be considered

3. Meningioma:

• highly vascular extra-axial neoplasm 
• core is supplied by branches of the ECA while periphery is supplied by the ICA
• "spoke wheel" appearance on angiogram
• resection is usually curative
• large tumors may be embolized prior to resection

REFERENCES

Pribram HFW. Selective catheterization of the external carotid artery. Radiology 1966;87:315-20.

Roberson GH, Price AC, Davis JM, et al. Therapeutic embolization of juvenile angiofibroma. AJR Am J Roentgenol 1979;133:657-63.

Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol 2009;3(4)303-6.

Wilson G, Weidner W, Hanafee W. The demonstration and diagnosis of meningiomas by selective catheter angiography. AJR Am J Roentgenol 1965;95(4):868-73.