Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres. An experience of 69 cases.
OBJECTIVE
To evaluate polymethyl methacrylate hydrogel microspheres (HMs) as an embolization material in the management of hypervascular craniofacial and spinal lesions.


METHODS
Sixty-nine patients with vascular lesions of the craniofacial and spinal regions underwent embolization with HM. The pathologies included craniofacial tumours (n=38), cranial arteriovenous malformations (AVMs) (n=7), dural AVM (n=1), cavernous carotid fistula (n=1), spinal tumours (n=7), spinal AVMs (n=6), orbital lesions (n=4) and scalp AVMs (n=5). Surgery was done in 56 patients. The blood loss at surgery, tumour shrinkage, surgical cleavage and ease of removal of tumour was noted from the records. Histopathology was available in 39 patients. A follow-up of 3 months to 6 years was available in 13 patients in whom embolization was the sole treatment. Surgical and histopathological findings were correlated with angio-embolization findings.


RESULTS
HMs were easy to inject through the microcatheter with good control. Good devascularization was obtained in 61 patients and partial in 8 patients. Two patients developed complications due to presence of anastomoses between intra- and extracranial circulation and 1 patient due to tumor swelling. Histopathology showed presence of HMs in all the lesions, with minimal inflammatory reaction in 2 patients. Patients with spinal lesions treated with embolization only stabilised in neurologic deficits.


CONCLUSIONS
HMs are highly suitable as embolization agents in the management of craniofacial and spinal hypervascular lesions.
Phadke
Rajendra  V
R
Department of Radiodiagnosis, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Rae Barely Road, Lucknow, U.P., India 226 014.
Venkatesh
S K
SK
Kumar
S
S
Tandon
V
V
Pandey
R
R
Tyagi
I
I
Jain
V K
VK
Chhabra
D K
DK
D016587:Antimutagenic Agents / Q000627:therapeutic use*; D020785:Central Nervous System Vascular Malformations / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic; D005153:Facial Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000627:therapeutic use*; D008863:Microspheres; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000473:pathology / Q000628:therapy*; D013125:Spinal Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
D016587:Antimutagenic Agents; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D019904:Polymethyl Methacrylate