J Neurol Surg B Skull Base 2018; 79(S 04): S328-S333
DOI: 10.1055/s-0038-1667043
WFSBS 2016
Georg Thieme Verlag KG Stuttgart · New York

Safety and Efficacy of Preoperative Embolization in Patients with Meningioma

Hiroshi Manaka
1   Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
,
Katsumi Sakata
1   Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
,
Junya Tatezuki
1   Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
,
Tadao Shinohara
1   Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
,
Wataru Shimohigoshi
1   Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
,
Tetsuya Yamamoto
2   Department of Neurosurgery, Yokohama City University, Postgraduate School of Medicine, Yokohama, Japan
› Author Affiliations
Further Information

Publication History

17 January 2018

06 June 2018

Publication Date:
23 July 2018 (online)

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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.