Surgical therapy of vascular tumors and paragangliomas

If you suffer from a tumor that is located in the area of the carotid artery, it usually originates from nerves of the autonomic nervous system. Fortunately, most of these tumors are benign. Only about 2-15% of tumors are malignant.

It is not unusual if the tumor was discovered by chance, as these tumors often do not cause any symptoms. However, you may have noticed the tumor because you became hoarse or your throat became swollen. If you currently have a lump on your neck that has not yet been clarified, you should have an ultrasound examination of the vessels or other imaging such as a computer tomography or magnetic resonance imaging. Paragangliomas in the area of the carotid artery can grow together with the carotid artery to varying degrees. The extent to which the tumor has grown together with the vessel influences the extent of the operation.

Available options at the University Hospital Zurich

Low-growth tumors can often be removed without having to replace your carotid artery. We make an incision in the neck and look for the tumor. Then we carefully peel it off the carotid artery as a whole. The removed tissue is then sent for tissue analysis to determine whether the tumor is benign or malignant. Depending on the size of the tumor, we may have to use a catheter technique to obliterate the vessels supplying the tumor before the actual operation.
If the tumor has grown more strongly into the vessel, we may have to remove parts of your carotid artery and replace the removed parts with a patch. In the case of very overgrown tumors, we may even have to remove your cervical artery and replace it with a synthetic tube. For this, too, we make an incision in the neck, locate the tumor and try to detach it from the vessel. If this is not successful, we clamp your artery for a short time and then remove the affected part. We then replaced the defect with a patch or a plastic tube. We then sew the cut to the neck. This is done with a suture that runs through the skin and a thread that dissolves by itself. We also insert a drainage so that the wound water can drain away. This is usually removed on the first or second day after the operation.

Preparation

You should let us know in advance if you are taking blood thinners so that we can decide which medication you should stop taking before the operation and for how long.
We will also decide whether you can continue to take your medication.

Procedure

  • Anesthesia: This procedure is performed under general anesthesia
  • Duration of the procedure: The duration depends on the degree of adhesion to the carotid artery. On average, you can expect an operation time of 1.5-3 hours.
  • Period of hospitalization: One day before the procedure, on the day of the procedure and two to three days afterwards
  • Histology: We send your tissue for histological examination on the day of the operation. This lasts an average of five days.

Aftercare

We use suture material that dissolves by itself so that no stitches need to be removed. After six weeks, an ultrasound of the carotid artery should be performed as a check-up. We offer to carry out this check at the USZ. Depending on the results of the histological examination, you should also have regular check-ups with an oncologist. In addition, you should have an ultrasound of the carotid artery performed every year, including the opposite side, as the tumor can occur on both sides.

Interdisciplinarity at the University Hospital Zurich

Interdisciplinary teams of angiologists, vascular surgeons, oncologists and radiologists treat several patients each year at the University Hospital Zurich.
Our doctors therefore have extensive experience in the diagnosis and monitoring of the clinical course of paragangliomas.

For patients

Register for your first appointment directly at the Clinic for Vascular Surgery.

Tel. +41 44 255 20 39
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For transfers

Simply assign your patients online. University Hospital Zurich Clinic for Vascular Surgery Rämistrasse 100 8091 Zurich

Tel. +41 44 255 20 39
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