title: Necrosis score, surgical time, and transfused blood volume in patients treated with preoperative embolization of intracranial meningiomas. Analysis of a single-centre experience and a review of literature.
abstract: OBJECTIVE
  Several authors have demonstrated that preoperative embolization of meningiomas reduces blood loss during surgery. However, preoperative embolization is still under debate. Aim of this study is the retrospective evaluation of necrosis score, surgical time, and transfused blood volume, on patients affected by intracranial meningiomas treated with preoperative embolization before surgery, compared with a control group treated only with surgery.
  
  
  METHODS
  Twenty-eight patients with meningiomas were subjected to a preoperative embolization with polyvinyl alcohol (PVA). These patients were divided into two groups: group 1, patients with preoperative embolization performed at least 7 days before surgery; and group 2, patients with preoperative embolization performed less than 7 days before surgery. A statistical evaluation was made by comparing necrosis score, surgical time, and transfused blood volume of these groups. Then, we compared these parameters also with group 3, which included patients with surgically treated meningioma who did not undergo preoperative embolization.
  
  
  RESULTS
  Surgery time and transfused blood volume were significantly lower in patients who had been embolized at least 7 days before definitive surgery. Furthermore, large confluent areas of necrosis were significantly more frequent in patients with a larger time span between embolization and surgery.
  
  
  CONCLUSIONS
  Preoperative embolization with PVA in patients with intracranial meningiomas is safe and effective, as it reduces the volume of transfused blood during surgical operation. However, patients should undergo surgery at least 7 days after embolization, as a shorter time interval has been correlated with a longer surgical time and a higher transfused blood volume.
authors.affiliation: Department of Radiological Sciences, Neuroradiology Unit, University of Messina, Via Malafata N°43, Messina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nania
authors.forename: F
authors.initials: F
authors.lastname: Granata
authors.forename: S
authors.initials: S
authors.lastname: Vinci
authors.forename: A
authors.initials: A
authors.lastname: Pitrone
authors.forename: V
authors.initials: V
authors.lastname: Barresi
authors.forename: R
authors.initials: R
authors.lastname: Morabito
authors.forename: N
authors.initials: N
authors.lastname: Settineri
authors.forename: F
authors.initials: F
authors.lastname: Tomasello
authors.forename: C
authors.initials: C
authors.lastname: Alafaci
authors.forename: M
authors.initials: M
authors.lastname: Longo
mesh_terms: D001803:Blood Transfusion; D001811:Blood Volume Determination; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008579:Meningioma / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D009336:Necrosis / Q000175:diagnosis / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000379:methods*; D061646:Operative Time; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D011142:Polyvinyl Alcohol