Semin intervent Radiol 2013; 30(03): 263-277
DOI: 10.1055/s-0033-1353479
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contemporary Endovascular Embolotherapy for Meningioma

Gregory J. Dubel
1   Department of Diagnostic Imaging, Division of Interventional Radiology Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
,
Sun Ho Ahn
1   Department of Diagnostic Imaging, Division of Interventional Radiology Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
,
Gregory M. Soares
1   Department of Diagnostic Imaging, Division of Interventional Radiology Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
13. September 2013 (online)

Preview

Abstract

Preoperative endovascular tumor embolization has been used for 40 years. Meningiomas are the most common benign intracranial tumor in which preoperative embolization has been most extensively described in the literature. Advocates of embolization report that it reduces operative blood-loss, and softens the tumor, thus making surgery safer and easier. Opponents suggest that it adds additional risk and cost for patients without controlled studies showing conclusive benefit. The literature suggests a 3 to 6% neurological complication rate related to embolization. The combined external and internal carotid artery blood supply and complex anastomoses of the meninges can make embolization challenging. Positive outcomes require thorough knowledge of the pertinent vascular anatomy, familiarity with the neurovascular equipment and embolics, and meticulous technique. There remains debate on several aspects of embolization, including tumors most appropriate for embolization, embolic agent of choice, ideal size of embolic, and the choice of vessel(s) to embolize. This detailed review of pertinent vascular anatomy, embolization technique, results, and complications should allow practitioners to maximize treatment outcomes in this setting.