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P-012 Endovascular Management of Inoperable Meningioma
  1. W Yakes
  1. Vascular Malformation Center, Englewood, CO

Abstract

Purpose To determine the efficacy of ethanol embolisation of single and multiple meningiomas in poor surgical candidates and in recurrent lesions.

Materials and Methods 11 patients (8 female, 3 male; mean age 52 yrs) underwent clinical, MR, and arteriographic evaluations. In patients who had post-surgical recurrence and/or were poor operative risks, ethanol embolisation was offered as an alternative procedure. Two patients that had multiple meningiomas related to Von Recklinghausen’s Neurofibromatosis Type II were offered endovascular ethanol treatments as multiple surgical craniotomies with excision were not possible.

Results All patients underwent ethanol embolisation of single and multiple pedicles supplying the tumour. Four patients suffered complications (1 patient minor late SAH without sequelae, 2 patients transient 6th nerve palsy, 1 patient transient worsening for 2 weeks of his aphasia). MR and CT demonstrated significant necrosis and shrinkage of the tumours at long-term follow-up (range: 6–72 mos; mean: 30 mos).

Conclusion Ethanol, being a liquid agent, penetrates to the capillary level causing necrosis and exclusion of collateral flow. This leads to tumour necrosis and shrinkage. Taking advantage of the slow-growing, non-metastasising characteristics and increased vascularity of this tumour, ethanol is an attractive alternative therapy that is minimally invasive. This treatment can be offered in selected poor surgical patients and in patients who developed post-operative recurrence. This procedure is efficacious in highly vascular tumours and in poorly vascularised meningiomas that are not possible to treat by endovascular approaches.

Disclosures W. Yakes: None.

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