Abstract
Preoperative embolization for intracranial meningioma has remained controversial for
several decades. In this study, we retrospectively reviewed our experience of embolization
using particulate embolic material and coil to clarify the therapeutic efficacy, safety,
and risk of complication.
Methods We reviewed 69 patients who underwent embolization with particulate embolic material
followed by surgical resection. An additional 6 procedures were included for patients
in whom recurrence was treated, for a total of 75 procedures of preoperative embolization.
We analyzed the following clinical data: age, sex, tumor size pathology, complications
related to embolization, and surgeon's opinion on the intraoperative ease of debulking
and blood transfusion. Embolization was performed mainly from the branches of the
external carotid artery.
Results No allogenic blood transfusions were needed for any patients. The surgeon had the
opinion that whitening and softening of the tumor allowed for easy debulking during
decompression of the tumor in most of the patients. Hemorrhagic complications were
seen in two patients after embolization. Emergency tumor removal was performed in
both of those patients, and they were recovered well after surgery. Transient cranial
nerve palsy was seen in one patient. One ischemic complication and one allergic complication
occurred.
Conclusion Preoperative embolization could give us an advantage in surgery for meningioma. The
procedure reduces intraoperative blood loss and operating time by softening the tumor
consistency. However, we must pay attention to the possibility of embolic complications
and keep the preparation of emergency craniotomy, particularly in patients with large
meningiomas.
Keywords
meningioma - preoperative embolization - endovascular technique - surgical treatment
