Therapeutic embolization of meningiomas with Onyx for delayed surgical resection.
BACKGROUND
Liquid embolic agents can achieve penetration of capillaries in tumors and thus may be even more effective at creating tumor necrosis than small particles. This study assesses the safety and efficacy of preoperative embolization of meningiomas with Onyx liquid embolic agent (Micro Therapeutics, Inc, Irvine, Calif) for delayed surgical resection.


METHODS
Three cases of hypervascular intracranial meningiomas were treated by preoperative embolization with Onyx embolic agent using superselective catheterization of the feeding arteries from the ECA and the reflux-hold-reinjection technique.


RESULTS
Meningiomas were devascularized successfully, and these patients did not present the symptoms of postembolization tumor swelling or hemorrhage before complete resection of the tumors 10 days later. Massive tumor necrosis was observed in all 3 cases of pathologic specimens, and shrinkage of tumor was seen by MRI as early as 8 days in 1 case. All patients had no recurrence of tumor at 12-month follow-up.


CONCLUSIONS
Preoperative embolization with Onyx may be a useful tool for treatment of meningiomas. Palliative embolization treatment of nonresectable hypervascular intracranial tumors with Onyx warrants future clinical investigation.
Shi
Zhong-Song
ZS
Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Feng
Lei
L
Jiang
Xiao-Bing
XB
Huang
Quan
Q
Yang
Zheng
Z
Huang
Zheng-Song
ZS
D000328:Adult; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000628:therapy*; D008579:Meningioma / Q000628:therapy*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011145:Polyvinyls / Q000627:therapeutic use*
C505752:Onyx HD 500; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide