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Standalone Meningioma Embolization: A Systematic Review.

Ian C Odland1,2, Lily Huo1,2, Rui Feng1

  • 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York, USA.

Neurosurgery
|February 9, 2026
PubMed
Summary

Standalone embolization shows promise as a safer alternative treatment for meningiomas, especially for patients who cannot undergo surgery. This minimally invasive approach offers significant tumor shrinkage and symptom relief with a low complication rate.

Keywords:
EmbolizationMeningiomaPalliativeSEStandaloneSymptomatic improvementTumor ischemiastandard error

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Area of Science:

  • Neurosurgery
  • Interventional Radiology
  • Oncology

Background:

  • Meningiomas are common intracranial tumors, with surgery as the standard treatment.
  • Recurrence rates after surgery can be as high as 40%, and reoperation carries significant risks.
  • Elderly or frail patients often have limited treatment options due to surgical morbidity.

Purpose of the Study:

  • To evaluate the efficacy and safety of embolization as a standalone treatment for meningiomas.
  • To assess outcomes in patients unsuitable for surgery or refractory to other treatments.

Main Methods:

  • A systematic review was conducted following PRISMA guidelines.
  • Searched PubMed/MEDLINE and EMBASE for studies on standalone meningioma embolization.
  • Extracted data on patient demographics, tumor characteristics, embolic agents, outcomes, and complications.

Main Results:

  • 121 patients from 34 studies were identified.
  • Symptomatic improvement in 77% and radiographic shrinkage in 84% of patients.
  • Major complication rate was 5%, comparable to preoperative embolization and lower than surgery.

Conclusions:

  • Standalone embolization may offer a lower-risk alternative for select meningioma patients.
  • Further prospective studies are needed to confirm its safety and efficacy.
  • Ischemia-induced necrosis is a potential mechanism for tumor regression.