Preoperative embolization of meningiomas fed by ophthalmic branch arteries.
BACKGROUND
The efficacy of preoperative embolization for hypervascular meningiomas mainly fed by the branches of the ophthalmic arteries was examined.


METHODS
Five hypervascular meningiomas mainly fed by the branches of the ophthalmic arteries, four posterior ethmoidal arteries, one anterior falx artery, and one recurrent middle meningeal artery were embolized with Gel-foam powder, polyvinyl alcohol (PVA) particles, and/or microcoils as a preoperative treatment using a microcatheter.


RESULTS
Catheterization of the ophthalmic and tumor feeding artery was possible and feeding arteries and lesion embolization were effective to reduce the bleeding during surgery in all cases. In three cases, visual acuity and visual field were preserved. However, in one case, visual acuity and visual field defect appeared due to the migration of Gelfoam powder (Upjohn, Kalamazoo, MI) into the retinal artery. In another case, the retinal artery was embolized with the feeding arteries since the patient was already blind.


CONCLUSIONS
Embolization of hypervascular meningioma feeding vessels arising from the ophthalmic artery is possible and effective with preservation of vision, if embolic agents are injected gently enough not to reflux into the central retinal artery.
Terada
T
T
Department of Neurological Surgery, Wakayama Medical College, Japan.
Kinoshita
Y
Y
Yokote
H
H
Tsuura
M
M
Itakura
T
T
Komai
N
N
Nakamura
Y
Y
Tanaka
S
S
Kuriyama
T
T
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006490:Hemostatics; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply* / Q000601:surgery / Q000628:therapy*; D008579:Meningioma / Q000098:blood supply* / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging; D011142:Polyvinyl Alcohol; D011859:Radiography
D006490:Hemostatics; D011142:Polyvinyl Alcohol