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[Preoperative embolization for meningiomas using PVA particles].

A Kurata¹, H Saegusa, T Ohmomo

¹Department of Neurosurgery, Kitazato University, School of Medicine, Kanagawa, Japan.

No Shinkei Geka. Neurological Surgery

|April 1, 1992

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Preoperative embolization using Polyvinyl alcohol foam (PVA) particles and gelfoam effectively reduces blood loss in large, vascular skull base meningiomas. Peripheral embolization is crucial for preventing particle washout and thrombosis in irregular tumor vessels.

Area of Science:

Neurosurgery
Interventional Radiology
Oncology

Background:

Preoperative embolization is vital for surgically managing large, highly vascular skull base meningiomas.
It aims to reduce intraoperative blood loss and facilitate tumor resection.

Observation:

This study reports on 4 patients with large, vascular skull base meningiomas.
Embolization was performed using Polyvinyl alcohol foam (PVA) particles and gelfoam strips.
Techniques included EEG monitoring, use of Isosorbide dinitrate for vasospasm, and lidocaine injection tests.

Findings:

Successful embolization was achieved in all 4 cases without immediate complications.
One patient required a second embolization due to revascularization detected by angiography.

Related Experiment Videos

Peripheral embolization with gelfoam, in addition to central PVA particle embolization, was necessary in cases with large, irregular feeding vessels.

Implications:

Peripheral embolization may prevent PVA particle washout and subsequent thrombosis.
This technique enhances the safety and efficacy of preoperative embolization for complex meningiomas.
Optimizing embolization strategies can improve surgical outcomes for skull base tumors.