Preoperative embolization of meningiomas: Single center experience

Preoperative embolization of meningiomas: Single center experience

Aim: The aim of this study was to investigate the contribution of polyvinyl alcohol particle embolization to meningioma surgery. Materials and Methods: The study included 24 patients (19 women, 5 men) who were operated for meningioma at our institution between October 2018 and October 2019. Ten patients underwent tumor embolization with polyvinyl alcohol particles before meningioma surgery, while the other 14 patients were operated directly without embolization. Groups were constituted as with embolized and non-embolized before surgery.Patient and tumor characteristics, embolization procedure, operative blood loss, operative time, and complications were compared between patients with and without preoperative embolization. Results: The patients ranged in age between 28 and 79 years, with a mean age of 54.16±10.50. Mean operative time was 4.59 hours for the embolized patients and 4.72 hours for the non-embolized patients (p>0.05). Mean hemoglobin values were decreased by 1.25 g/dl in the embolized patients and 1.35 g/dl in the non-embolized patients (p>0.05). Conclusion: There were no significant differences in operative time, intraoperative blood loss, or change in hemoglobin level between meningioma patients who underwent preoperative embolization with polyvinyl alcohol particles and those who did not.

___

  • 1. Toh CH, Castillo M, Wong AM, et al. Differentiation between classic and atypical meningiomas with use of diffusion tensor imaging. AJNR Am J Neuroradiol 2008;29:1630-5.
  • 2. Perry A, Stafford SL, Scheithauer BW, et al. Suman VJ, Lohse CM. Meningioma grading: An analysis of histologic parameters. Am J Surg Pathol 1997;21:1455-65.
  • 3. Manelfe C, Lasjaunias P, Ruscalleda J. Preoperative embolization of intracranial meningiomas. AJNR Am J Neuroradiol 1986;7:963-72.
  • 4. Singla A, Deshaies EM, Melnyk V, et al. Controversies in the role of preoperative embolization in meningioma management. Neurosurg Focus 2013;35:e17.
  • 5. Carli DF, Sluzewski M, Beute GN, et al. Complications of particle embolization of meningiomas: frequency, risk factors, and outcome. AJNR Am J Neuroradiol 2010;31:152-4.
  • 6. Hirschl R, Caragine L.P. Endovascular techniques for tumor embolization. Winn HR (editor). Youmans Neurological Surgery. 6th Edition. Philadelphia, United States of America: Elsevier Saunders; 2011.p.224– 1228.
  • 7. Przybylowski CJ, Zhao X, Baranoski JF, et al. Preoperative embolization versus no embolization for WHO grade I intracranial meningioma: a retrospective matched cohort study. J Neurosurg 2020;27:1-8.
  • 8. Raper DM, Starke RM, Henderson F Jr, et al. Preoperative embolization of intracranial meningiomas: efficacy, technical considerations, and complications. AJNR Am J Neuroradiol 2014;35:1798-804.
  • 9. Mefty OA, Abdulrauf SI, Haddad GF. Meningiomas. Winn HR. Youmans Neurological Surgery. 6th Edition. Philadelphia: Elsevier Saunders; 2011.p.1426-49.
  • 10. Wakhloo AK, Juengling FD, Van Velthoven V, et al. Extended preoperative polyvinyl alcohol microembolization of intracranial meningiomas: assessment of two embolization techniques. AJNR Am J Neuroradiol 1993;14:571-82.
  • 11. Shah AH1, Patel N, Raper DM, et al. The role of preoperative embolization for intracranial meningiomas. J Neurosurg 2013;19:364-72.
  • 12. Manaka H, Sakata K, Tatezuki J, et al. Safety And Efficacy Of Preoperative Embolization In Patients With Meningioma. J Neurol Surg B Skull Base 2018;79:328- 33.
  • 13. Barros G, Feroze AH, Sen R, et al. MR. Predictors of preoperative endovascular embolization of meningiomas: subanalysis of anatomic location and arterial supply. J Neurointerv Surg 2020;12:204-8.
  • 14. Gruber P, Schwyzer L, Klinger E et al. Longitudinal Imaging Of Tumor Volume, Diffusivity, And Perfusion After Preoperative Endovascular Embolization In Supratentorial Hemispheric Meningiomas. World Neurosurg 2018;120:357-64.
  • 15. Wen Ll, Zhang X, Zhang Qr et al. Flat-Detector Computed Tomography PBV Map In The Evaluation Of Presurgical Embolization For Hypervascular Brain Tumors. J Neurointerv Surg 2017;9:1139-44.
  • 16. Rodiek SO, Stolzle A, Lumenta CB. Preoperative embolization of intracranial meningiomas with Embosphere microspheres. Minim Invasive Neurosurg 2004;47:299-305.
  • 17. Bendszus M, Rao G, Burger R, et al. Is There A Benefit Of Preoperative Meningioma Embolization?. Neurosurgery 2000;47:1306-12.
  • 18. Ilyas A, Przybylowski C, Chen Cj,et al. Preoperative Embolization Of Skull Base Meningiomas: A Systematic Review. J Clin Neurosci 2019;59:259-64.
  • 19. Brandel Mg, Rennert Rc, Wali Ar, et al. Impact Of Preoperative Endovascular Embolization On Immediate Meningioma Resection Outcomes. Neurosurg Focus 2018;44:e6.
  • 20. Dowd CF, Halbach VV, Higashida RT. Meningiomas: the role of preoperative angiography and embolization. Neurosurg Focus 2003;15:e10.
  • 21. Lacobucci M, Danieli L, Visconti E, et al. Preoperative embolization of meningiomas with polyvinyl alcohol particles: The benefits are not outweighed by risks. Diagn Interv Imaging 2017;98:307-14.
  • 22. Kizilkilic O, Kocer N. Embolization in meningiomas. Turkish J Neurosurgery 2011;21:178-81.
  • 23. Przybylowski Cj, Baranoski JF, See Ap, et al. Preoperative Embolization Of Skull Base Meningiomas: Outcomes In The Onyx Era. World Neurosurg 2018;116:e371-9.
  • 24. Grand C, Bank WO, Balériaux D, et al. Gadoliniumenhanced MR in the evaluation of preoperative meningioma embolization. AJNR Am J Neuroradiol 1993;148:563-9.
  • 25. Richter HP, Schachenmayr W. Preoperative embolization of intracranial meningiomas. Neurosurgery 1983;13:261-8.
  • 26. Kai Y, Hamada J, Morioka M, Yano S, Todaka T, UshioY. Appropriate interval between embolization and surgery in patients with meningioma. AJNR Am J Neuroradiol 2002;23:139-42.
  • 27. Men S. Preoperative embolization in Head-Neck tumors. Trd Sem 2018;6:98-108.
  • 28. Borg A, Ekanayake J, Mair R, et al. Preoperative particle and glue embolization of meningiomas: indications, results and lessons learned from 117 consecutive patients. Neurosurgery 2013;73:244-51.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi