Usefulness of Percutaneously Injected Ethylene-Vinyl Alcohol Copolymer in Conjunction with Standard Endovascular Embolization Techniques for Preoperative Devascularization of Hypervascular Head and Neck Tumors: Technique, Initial Experience, and Correlation with Surgical Observations

A and B, Axial CT images show a large JNA (arrowheads) within the infratemporal fossa, maxillary sinus, and nasal cavity, extending intracranially. C and D, Intra-arterial CTA; MIP image (C) and surface rendering display (D) show the large JNA (small arrow) with supply off the ECA and ICA. E, Axial CT image placement of needles into the mass from an infrazygomatic approach. F and G, AP (F) and lateral (G) ECA angiogram showing the hypervascularity of the JNA (small arrow). H and I, AP (H) and lateral (I) unsubtracted images show the Onyx cast in the tumor bed. J and K, AP (J) and lateral (K) ECA angiograms immediately after embolization, showing that the tumor is devascularized. L, Lateral ICA angiogram shows no arterial feeders supplying the tumor.