Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Clinical Neuroradiology
Published in: Clinical Neuroradiology 1/2014

01-03-2014 | Original Article

Necrosis Score, Surgical Time, and Transfused Blood Volume in Patients Treated with Preoperative Embolization of Intracranial Meningiomas. Analysis of a Single-Centre Experience and a Review of Literature

Authors: A. Nania, MD, F. Granata, MD, S. Vinci, MD, A. Pitrone, MD, V. Barresi, MD, R. Morabito, MD, N. Settineri, MD, F. Tomasello, MD, C. Alafaci, MD, M. Longo, MD

Published in: Clinical Neuroradiology | Issue 1/2014

Login to get access

Abstract

Purpose

Several authors have demonstrated that preoperative embolization of meningiomas reduces blood loss during surgery. However, preoperative embolization is still under debate. Aim of this study is the retrospective evaluation of necrosis score, surgical time, and transfused blood volume, on patients affected by intracranial meningiomas treated with preoperative embolization before surgery, compared with a control group treated only with surgery.

Method

Twenty-eight patients with meningiomas were subjected to a preoperative embolization with polyvinyl alcohol (PVA). These patients were divided into two groups: group 1, patients with preoperative embolization performed at least 7 days before surgery; and group 2, patients with preoperative embolization performed less than 7 days before surgery. A statistical evaluation was made by comparing necrosis score, surgical time, and transfused blood volume of these groups. Then, we compared these parameters also with group 3, which included patients with surgically treated meningioma who did not undergo preoperative embolization.

Results

Surgery time and transfused blood volume were significantly lower in patients who had been embolized at least 7 days before definitive surgery. Furthermore, large confluent areas of necrosis were significantly more frequent in patients with a larger time span between embolization and surgery.

Conclusion

Preoperative embolization with PVA in patients with intracranial meningiomas is safe and effective, as it reduces the volume of transfused blood during surgical operation. However, patients should undergo surgery at least 7 days after embolization, as a shorter time interval has been correlated with a longer surgical time and a higher transfused blood volume.
Literature
1.
Rachlin JR, Rosenblum ML. Etiology and biology of meningiomas. In: Al-Mefty O, editor. Meningiomas. New York: Raven Press; 1991. p. 27–36.
2.
3.
Cushing H. The meningiomas (dural endotheliomas): their source, and favoured seats of origin. Brain. 1922;45:282–316.CrossRef
4.
Boulos PT, Dumont AS, Mandell JW, et al. Meningiomas of the orbit: contemporary considerations. Neurosurg Focus. 2001;10(5):E5 (Review).PubMed
5.
Russell DS, Rubinstein LJ. Tumors of meninges and of related tissues. In: Russell DS, Rubinstein LJ, editors. Pathology of tumors of the nervous system. 4th ed. Baltimore: Williams & Wilkins; 1977. p. 62–100.
6.
Manelfe C, Guiraud B, David J, et al. Embolization by catheterization of intracranial meningiomas. Rev Neurol (Paris). 1973;128:339–51.
7.
Vilalta J, Arikán F, Noguer M, et al. Resultados del tratamiento quirúrgico en 100 pacientes con malformaciones arteriovenosas cerebrales. Rev Neurol. 2007;44:449–55.PubMed
8.
Hieshima GB, Everhart FR, Mehringer CM, et al. Preoperative embolization of meningiomas. Surg Neuro. 1980;14(2):119–27.
9.
Hekster RE, Matricali B, Luyendijk W. Presurgical transfemoral catheter embolization to reduce operative blood loss: technical note. J Neurosurg. 1974;41:396–8.PubMedCrossRef
11.
Perry A, Louis DN, Scheithauer BW, et al. Meningiomas. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, editors. WHO classification of tumors of the central nervous system. Lyon: IARCC Press; 2007. p. 164–72.
11.
Perry A, Chicoine MR, Filiput E, Miller JP, Cross DT. Clinicopathologic assessment and grading of embolized meningiomas: a correlative study of 64 patients. Cancer. 2001;92(3):701–11.PubMedCrossRef
12.
Vinuela F, Halbach VV, Hieshima GB, et al. Endovascular therapy of head and neck tumors. In: Vinuela F, Halbach VV, Dion JE, editors. Interventional neuroradiology—endovascular therapy of the central nervous system. New York: Raven Press; 1992. p. 17–28 (Chapter 2).
13.
Berenstein A, Lasjaunias P, et al. Dural and bony tumors. In: Berenstein A, Lasjaunias P, ter Brugge KG, editors. Surgical neuroangiography. 2nd ed. New York: Springer-Verlag; 2004. p. 153–200 (Chapter 2).CrossRef
14.
Dowd CF, Halbach VV, Higashida RT. Meningiomas: the role of preoperative angiography and embolization. Neurosurg Focus. 2003;15(1):E10 (Review).PubMed
15.
Manelfe C, Lasjaunias P, Ruscalleda J. Preoperative embolization of intracranial meningiomas. AJNR Am J Neuroradiol. 1986;7(5):963–72.PubMed
16.
Tadavarthy SM, Moller JH, Amplatz K. Polyvinyl alcohol (Ivalon)—a new embolic material. Am J Roentgenol Radium Ther Nucl Med. 1975;125(3):609–16.PubMedCrossRef
17.
Macpherson P. The value of pre-operative embolisation of meningioma estimated subjectively and objectively. Neuroradiology. 1991;33(4):334–7.PubMedCrossRef
18.
Gruber A, Killer M, Mazal P, et al. Preoperative embolization of intracranial meningiomas: a 17-years single center experience. Minim Invasive Neurosurg. 2000;43(1):18–29.PubMedCrossRef
19.
Wakhloo AK, Juengling FD, Van Velthoven V, et al. Extended preoperative polyvinyl alcohol microembolization of intracranial meningiomas: assessment of two embolization techniques. AJNR Am J Neuroradiol. 1993;14(3):571–82.PubMed
20.
Latchaw RE, Gold LH. Polyvinyl foam embolization of vascular and neoplastic lesions of the head, neck, and spine. Radiology. 1979;131(3):669–79.PubMed
21.
Derdeyn CP, Moran CJ, Cross DT, et al. Polyvinyl alcohol particle size and suspension characteristics. AJNR Am J Neuroradiol. 1995;16(6):1335–43.PubMed
22.
Bendszus M, Klein R, Burger R, et al. Efficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles in the preoperative embolization of meningiomas. AJNR Am J Neuroradiol. 2000;21(2):255–61.PubMed
23.
Richter HP, Schachenmayr W. Preoperative embolization of intracranial meningiomas. Neurosurgery. 1983;13(3):261–68.PubMedCrossRef
24.
Lefkowitz M, Giannotta SL, Hieshima G, et al. Embolization of neurosurgical lesions involving the ophthalmic artery. Neurosurgery. 1998;43(6):1298–303.PubMed
25.
Bendszus M, Monoranu CM, Schutz A, et al. Neurologic complications after particle embolization of intracranial meningiomas. AJNR Am J Neuroradiol. 2005;26(6):1413–9.PubMed
26.
Carli DF, Sluzewski M, Beute GN, et al. Complications of particle embolization of meningiomas: frequency, risk factors, and outcome. AJNR Am J Neuroradiol. 2010;31(1):152–4.PubMedCrossRef
27.
Kallmes DF, Evans AJ, Kaptain GJ, et al. Hemorrhagic complications in embolization of a meningioma: case report and review of the literature. Neuroradiology. 1997;39(12):877–80.PubMedCrossRef
28.
Rosen CL, Ammerman JM, Sekhar LN, et al. Outcome analysis of preoperative embolization in cranial base surgery. Acta Neurochir (Wien). 2002;144(11):1157–64.CrossRef
29.
Quinones-Hinojosa A, Kaprealian T, Chaichana KL, et al. Pre-operative factors affecting resectability of giant intracranial meningiomas. Can J Neurol Sci. 2009;36(5):623–30.PubMed
30.
Bendszus M, Rao G, Burger R, et al. Is there a benefit of preoperative meningioma embolization? Neurosurgery. 2000;47(6):1306–11; discussion: 1311–2.PubMedCrossRef
31.
Dean BL, Flom RA, Wallace RC, et al. Efficacy of endovascular treatment of meningiomas: evaluation with matched samples. AJNR Am J Neuroradiol. 1994;15(9):1675–80.PubMed
32.
Gruber A, Bavinzski G, Killer M, et al. Preoperative embolization of hypervascular skull base tumors. Minim Invasive Neurosurg. 2000;43(2):62–71.PubMedCrossRef
33.
Ellis JA, D’Amico R, Sisti MB, et al. Pre-operative intracranial meningioma embolization. Expert Rev Neurother. 2011;11(4): 545–56.PubMedCrossRef
34.
Ng HK, Poon WS, Goh K, et al. Histopathology of post-embolized meningiomas. Am J Surg Pathol. 1996;20(10):1224–30.PubMedCrossRef
35.
Chun JY, McDermott MW, Lamborn KR, et al. Delayed surgical resection reduces intraoperative blood loss for embolized meningiomas. Neurosurgery. 2002;50(6):1231–5; discussion: 1235–7.PubMed
36.
Kai Y, Hamada J, Morioka M, et al. Appropriate interval between embolization and surgery in patients with meningioma. AJNR Am J Neuroradiol. 2002;23(1):139–42.PubMed
Metadata
Title
Necrosis Score, Surgical Time, and Transfused Blood Volume in Patients Treated with Preoperative Embolization of Intracranial Meningiomas. Analysis of a Single-Centre Experience and a Review of Literature
Authors
A. Nania, MD
F. Granata, MD
S. Vinci, MD
A. Pitrone, MD
V. Barresi, MD
R. Morabito, MD
N. Settineri, MD
F. Tomasello, MD
C. Alafaci, MD
M. Longo, MD
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 1/2014
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-013-0215-0

Other articles of this Issue 1/2014

Clinical Neuroradiology 1/2014 Go to the issue

Correspondence

Diminished Visibility of Cerebral Venous Vasculature in Subclinical Status Epilepticus by Susceptibility-Weighted Imaging: A Case Report

Correspondence

Isolated Developmental Venous Anomaly of the Pons with Transpontine Drainage: Case Report

Original Article

Diffusion Tensor Imaging in Amyotrophic Lateral Sclerosis—Increased Sensitivity with Optimized Region-of-Interest Delineation


Original Article

Angiographic C-arm CT visualization of the Woven EndoBridge Cerebral Aneurysm Embolization Device (WEB): First Experience in an Animal Aneurysm Model

Correspondence

Spontaneous Multiple-Channel Recanalization of Internal Carotid Artery Occlusion with Unusual Radiological Features

Review Article

Stent-Retriever Thrombectomy: Impact on the Future of Interventional Stroke Treatment