Phenytoin as a liquid material for embolisation of tumours

We carried out embolisation with phenytoin in seven patients with meningiomas; in three by cannulation of the middle meningeal artery during surgery and in four by microcatheter introduced into the middle meningeal artery. Phenytoin (125-500 mg) diluted with saline (25 mg/ml) was injected slowly as a bolus. There was no evidence of devascularisation in two meningiomas treated with 125 mg and 150 mg of phenytoin. Large areas of ischaemic and haemorrhagic necrosis were found in five meningiomas treated with 250-500 mg. After embolisation, the tumour blush disappeared, with preservation of the feeding arteries. Total resection of the tumour was performed with minimum blood loss. Caution and proper use are emphasised to avoid increase in tumour volume and reflux. Phenytoin could be a suitable material for superselective embolisation.