[Preoperative embolisation with absorbable gelatine sponge in intracranial meningiomas].
OBJECTIVE
The purpose of this study was to evaluate the benefits of preoperative embolisation with an absorbable gelatine sponge in selected intracranial meningiomas.


METHODS
We performed a retrospective study of a series of 33 patients who had undergone surgery for meningiomas with a diameter of over 4 cm between the years 2000 and 2007. Two groups were analysed: group A (n = 16) with preoperative embolisation and group B (n = 17) without it. Eligibility criteria for embolisation were: exclusive or predominant irrigation through the external carotid artery, high tumour flow and pronounced vascularisation through the pial branches. The location of the lesion was evaluated preoperatively; blood losses, number of units of blood transfused, surgery time and surgeon's opinion were evaluated intraoperatively.


RESULTS
A statistically significant difference was found between the group of embolised patients and those who had not been embolised as far as surgery time (217.5 +/- 69.61 versus 291.76 +/- 56.94 min; p =< 0.002) and blood loss (613.75 +/- 231.42 versus 987.65 +/- 206.68 mL; p => 0.001) were concerned. A positive coloration (r = 0.568; p = 0.001) was found between surgery time and blood loss. No statistically significant relation was observed between age and the number of units of blood transfused. Embolisation was considered to be beneficial by 75% of surgeons.


CONCLUSIONS
Preoperative embolisation with an absorbable gelatine sponge in patients with intracranial meningiomas with a diameter above 4 cm and exclusive or predominant irrigation by the external carotid artery is effective and safe; it also reduces intraoperative bleeding and surgery time.
Alberione
F
F
Servicio de Neurocirugía, Hospital General Agudos Donación F. Santojanni, Buenos Aires, Argentina. falberione@hotmail.com
Iturrieta
P
P
Schulz
J
J
Masenga
G
G
del Giudice
G
G
Ripoli
M
M
Cascarino
J
J
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D008297:Male; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult