Purpose One of the most important issues in the surgical treatment of large hypervascular meningiomas is the securing and coagulation of feeding arteries. However, securing the feeding artery prior to actual tumor resection might be difficult in tumors with a feeding artery arising from the deep surface of the operative field. For such cases, we performed selective feeder embolization before tumor resection. This study evaluated the clinical usefulness of preoperative embolization of the dural branch of the internal carotid artery (ICA) for brain tumor.
Clinical material Subjects comprised 21 consecutive patients with large hypervascular meningioma fed by ICA dural branche (Meningohypophyseal artery: 14, Infero-lateral trunk: 9, Ethomoidal Artery: 1) Feeder embolizations were performed under local anesthesia 1 day before tumor resection. 2 or 1.7 F microcatheter and hydrophilic shapable micro guide wire and PVA (150–250 μ) were used.
Results Maximum tumor size were 30 to 72 (mean: 45.9) mm Almost complete embolization was obtained in nine patients, and a marked decrease in tumor staining was demonstrated in 13 patients. No complications related to endovascular procedures were encountered. Intraoperative control of bleeding was easily manages, with mean intraoperative blood loss of 536 ml. Although partial resection was possible due to cranial nerve adhesion to the tumor in two cases, total or sub total resection was achieved in 19 cases.
Conclusion Endovascular embolization of the feeding artery from ICA dural branch was safe and effective adjuvant therapy before tumor resection.
Competing interests None.
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