Abstract
During embolization of meningiomas, intratumoral hemorrhagic complications may occur, especially with the use of small particle sizes. We compared the rate of hemorrhagic complications in 55 patients embolized with 400-μm calibrated microspheres (Embozene) with a historical cohort of 198 patients embolized with smaller PVA particles. Between September 2009 and February 2012, fifty-five patients with 55 meningiomas were embolized with 400-μm calibrated microspheres. Indications for embolization were preoperative in 47 and before radiosurgery in 2 patients; and in 6 patients, embolization was offered as sole therapy. There were 35 women and 20 men with a mean age of 60.3 years. Mean meningioma diameter was 53 mm (range, 23-97 mm). Hemorrhagic complications were recorded. There were no hemorrhagic complications in the 55 embolized patients (0%; 95% CI, 0.0%-7.8%). The difference in complication rates between 400-μm calibrated microspheres in this study (0 of 55, 0%) and small PVA particles (45-150 μm) in the historical cohort (9 of 108, 8.3%) was just short of significance (P=.066). The difference in complication rates between 400-μm calibrated microspheres (0 of 55, 0%) and larger PVA particles (150-250 μm) in the historical cohort (1 of 93, 1.1%) was not significant (P=.8). In this series, embolization of meningiomas by using large (400-μm) calibrated microspheres did not result in any hemorrhagic complications.
Highlights
MethodsBetween September 2009 and February 2012, fifty-five patients with 55 meningiomas were embolized with 400-m calibrated microspheres
BACKGROUND AND PURPOSEDuring embolization of meningiomas, intratumoral hemorrhagic complications may occur, especially with the use of small particle sizes
The difference in complication rates between 400-m calibrated microspheres (0 of 55, 0%) and larger PVA particles (150 –250 m) in the historical cohort (1 of 93, 1.1%) was not significant (P ϭ .8). In this series, embolization of meningiomas by using large (400-m) calibrated microspheres did not result in any hemorrhagic complications
Summary
Between September 2009 and February 2012, fifty-five patients with 55 meningiomas were embolized with 400-m calibrated microspheres. General Between September 2009 and February 2012, fifty-five patients with 55 meningiomas were embolized in our institution. Indications for embolization were preoperative in 47 and before radiosurgery in 2 patients. In the remaining 6 patients, embolization was initially offered as a sole therapy. We assessed the following patient and imaging characteristics: AJNR Am J Neuroradiol 34:727–29 Apr 2013 www.ajnr.org 727 age, sex, indication for embolization, and meningioma size. The ophthalmic artery, the meningeohypophyseal trunk, or pial feeders were not used as access for embolization because of possible ischemic complications in these vascular territories. Hemorrhagic complications, defined as any extravasation of contrast material visible during embolization and confirmed on CT scanning, were recorded. Ischemic complications and blockage of the microcatheter were noted
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