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E-079 endovascular management of inoperable meningioma
  1. W Yakes
  1. Vascular Malformation Center, Englewood, CO, USA

Abstract

Purpose To determine the efficacy of ethanol embolization 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 embolization was offered as an alter-native procedure. Two patients that had multiple meningiomas related to Von Reck-linghausen’s Neurofibromatosis Type II were offered endovascular ethanol treatments as multiple surgical craniotomies with excision were not possible.

Results All patients underwent ethanol embolization of single and multiple pedicles supplying the tumor. 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 tumors 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 tumor necrosis and shrinkage. Taking advantage of the slow-growing, non-metastasizing characteristics and in-creased vascularity of this tumor, 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 tumors and in poorly vascularized meningiomas that are not possible to treat by endovascular approaches.

Disclosures W. Yakes: None.

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