title: Risks of presurgical embolization of feeding arteries in 137 intracranial meningeal tumors.
abstract: BACKGROUND
  Embolization of extra-axial tumors has shown its effectiveness in reducing perisurgical blood loss. However, the complication rate of this procedure is poorly reported. We aimed to evaluate the rate of procedure-related complications and their risk factors.
  
  
  METHODS
  From 1998 to 2011, 193 consecutive patients (141 females, 52 males; mean age = 52.9 years) were referred to our institution for presurgical embolization of an extra-axial tumor (meningiomas: n = 178; solitary fibrous tumors: n = 3; other: n = 12). Of 193 patients, 137 (71 %) underwent 141 embolizations (by microparticles: n = 133; by glue: n = 8). The remaining 56 patients (29 %) were not embolized due to unstable catheterization or dangerous anastomosis. Occurrence of neurological deficit was systematically assessed during and after embolization. The risk factors of procedure-related neurological complications were evaluated.
  
  
  RESULTS
  Neither intratumoral hemorrhage nor procedure-related death was reported. Two of the 137 patients (1.5 %) had ischemic events with permanent neurological deficit after microparticles embolization. One patient had cortical blindness and one had hemiparesis. Both complications involved the vertebrobasilar system. The first patient had direct intratumoral anastomosis between the middle and the posterior meningeal arteries (PMA); the second one had reflux in the vertebral artery during particles injection in the PMA. Occurrence of ischemic complication was not related to the size of the microparticles.
  
  
  CONCLUSIONS
  Though embolization of meningeal tumors is considered as a safe technique, serious neurological complications may occur. Opening of dangerous anastomosis or uncontrolled reflux caused two neurological complications (1.5 %). The size of the microparticles was not associated with the occurrence of neurological event.
authors: Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, Paris VI University, 47, Bd de l'Hôpital, 75013, Paris, France.
authors: Bruno
authors: B
authors: Law-ye
authors: Frédéric
authors: F
authors: Clarençon
authors: Nader-Antoine
authors: NA
authors: Sourour
authors: Federico
authors: F
authors: Di Maria
authors: Betty
authors: B
authors: Jean
authors: Fabrice
authors: F
authors: Bonneville
authors: Alessandra
authors: A
authors: Biondi
authors: Christina
authors: C
authors: Iosif
authors: Soledad
authors: S
authors: Navarro
authors: Philippe
authors: P
authors: Cornu
authors: Jacques
authors: J
authors: Chiras
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008579:Meningioma / Q000098:blood supply / Q000628:therapy*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000628:therapy*; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult