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Subselective preoperative embolization for meningiomas. A radiological and pathological assessment
Journal of Neurosurgery
|March 1, 1984
Summary
Preoperative embolization of meningiomas is a safe and effective method for reducing tumor vascularity and improving surgical outcomes. This technique helps induce tumor necrosis and control bleeding during surgery.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Oncology
Background:
- Meningiomas are tumors that arise from the meninges, the membranes that surround the brain and spinal cord.
- Preoperative embolization is a procedure used to reduce blood flow to a tumor before surgical removal.
- Evaluating the effectiveness of preoperative embolization in managing meningiomas is crucial for optimizing patient outcomes.
Purpose of the Study:
- To assess the impact of preoperative subselective embolization on meningioma vascularity and surgical intervention.
- To determine the reliability of imaging techniques in predicting embolization suitability and outcomes.
- To evaluate the safety and efficacy of embolization in inducing tumor necrosis and hemostasis.
Main Methods:
- A 2-year study involving 36 patients with meningiomas diagnosed via computerized tomography (CT).
- Selective internal and external carotid artery angiography was performed, with embolization of external carotid artery feeders in 27 cases.
- Post-embolization assessment included CT, dynamic radioisotope scans, surgical outcome recording, and examination of excised tumor specimens.
Main Results:
- Computerized tomography (CT) and dynamic radioisotope scans were unreliable in predicting tumor vascularity or suitability for embolization.
- These imaging modalities also proved unreliable in assessing post-embolization necrosis or blood flow reduction.
- Subselective embolization was found to be a simple, safe, and effective method for inducing tumor necrosis and achieving intraoperative hemostasis.
Conclusions:
- Preoperative subselective embolization is a valuable adjunct in the management of selected meningioma patients.
- Embolization effectively induces tumor necrosis and facilitates intraoperative hemostasis, simplifying surgical resection.
- Current imaging techniques have limitations in predicting embolization effectiveness and assessing post-procedure changes.