Preoperative embolization for glioblastoma surgery: A scoping review

Preoperative embolization for glioblastoma (GBM) is a relatively uncommon procedure, and few studies have described its role as an adjunct to surgery.

PubMed, MEDLINE via Ovid, and ScienceDirect were searched following the Preferred Reporting Items for Scoping Reviews guidelines. Embolic agents, clinical contexts for embolization, embolizationcraniotomy interval, surgical resection outcomes, follow-up duration, and clinical outcomes were evaluated.

The preliminary search identified 844 records. After screening, 7 studies with 25 patients published between 2006 and 2026 were included in the final review. GBM was embolized under conscious sedation in 15 of 22 cases (68.2%). The transradial access route was the most frequent approach for embolization (15 of 17, 88.2%). Among the 24 patients with available data on embolic agents, liquid embolic agents were used in 13, while coils were used in 11 patients. The interval between embolization and craniotomy was 1 day in 96% cases. All cases underwent embolization without procedure-related complications and subsequently had maximal safe resection of GBM, with a median estimated blood loss of 354 mL. Subgroup analysis by embolic agent revealed a lower median EBL in patients receiving coils alone (295 mL), compared with those receiving liquid embolic agents (402 mL). Four of six patients with available resection data underwent gross total resection of the tumor, and two had near-total resection. In this review, embolization was performed in diverse clinical scenarios, and no established selection criteria were found for preoperative embolization in GBM surgery.

Preoperative embolization in GBM surgery has been performed across distinct clinical scenarios. Currently, the literature does not provide universally established guidelines or patient selection criteria for preoperative embolization as an adjunct to hypervascular GBM surgery.