[Techniques and results after embolization of meningiomas (author's transl)]

The different techniques and results are described for a total of 25 preoperative tumor embolizations in 21 patients with meningiomas of diverse localizations and extents. Transfemoral catheter techniques were superior to direct punctures of the carotid arteries because of the easier handling of the catheters, the better superselectivity of angiography, and, consequently, the more exact placement of the emboli. The results of the embolizations depended on the localization of the meningiomas. Meningiomas of the convexities (six patients) turned out to be particularly susceptible to complete embolizations. Satisfactory results were achieved operatively and histologically through embolization in meningiomas of the falx with large parasagittal expansion as well as in those of the lateral sphenoid wing, the sylvian fissure, and the cavum Meckeli (nine patients). Embolization of tumors which were localized exclusively at the falx, the tentorium, or of more medially situated meningiomas of the sphenoid wing were without beneficial effect, since these are predominantly vascularized by branches of the internal carotid arteries. Provided the localization and vascularization of a tumor are favourable the application of superselective angiography and preoperative embolization represents an important improvement of the basic conditions for a later operation.