title: [Preoperative embolization with microspheres of giant supratentorial meningiomas: 5-year experience].
abstract: BACKGROUND
  Preoperative embolization of hypervascular tumours such as meningiomas has proven to be a favorable factor for resection of the latter because it diminishes intraoperative bleeding and the need for blood transfusions.
  
  
  OBJECTIVE
  Evaluation of surgical outcomes of preoperative embolization with microspheres of giant supratentorial meningiomas.
  
  
  METHODS
  We retrospectively analyzed patient records from 2007 to 2012 with the diagnosis of giant supratentorial meningiomas (> 5 cm) (n= 27) and obtained two samples: those with preoperative embolization (n= 14) and patients without any properative embolization (n= 13). We evaluated and compared statistically significant surgical bleeding, surgical time and resection grade (via Simpson scale). Additionally, we evaluated internal/external vascularization rate and the histopathologic diagnosis.
  
  
  RESULTS
  According to the Simpson scale, the mean resection grade was 1.21 for embolized meningiomas, whereas for non-embolized meningiomas it was 1.92 . No differences were found in surgical bleeding and operative time. We used microspheres whose diameters were 40-120 μm, and these were easily observed with common microscopy techniques. In all cases we observed predominance in extracranial vascularization. No morbidity and mortality were recorded with the endovascular procedure.
  
  
  CONCLUSIONS
  Embolization with microspheres improves resection rate evaluated by the Simpson scale in patients with giant supratentorial meningiomas.
authors.affiliation: Servicio de Neurocirugía, Hospital Juárez de México, Secretaría de Salud, México DF, Mexico.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Melo-Guzmán
authors.affiliation: Servicio de Neurocirugía, Hospital Juárez de México, Secretaría de Salud, México DF, Mexico. triskadeika@hotmail.com.
authors.forename: Víctor Hugo
authors.initials: VH
authors.lastname: Escobar-de la Garma
authors.affiliation: Servicio de Neurocirugía, Hospital Juárez de México, Secretaría de Salud, México DF, Mexico.
authors.forename: Felipe
authors.initials: F
authors.lastname: Padilla-Vázquez
authors.affiliation: Servicio de Neurocirugía, Hospital Juárez de México, Secretaría de Salud, México DF, Mexico.
authors.forename: Omar Antonio
authors.initials: OA
authors.lastname: Pérez-Morales
authors.affiliation: Servicio de Neurocirugía, Hospital Juárez de México, Secretaría de Salud, México DF, Mexico.
authors.forename: Rafael
authors.initials: R
authors.lastname: Mendizábal-Guerra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008579:Meningioma / Q000098:blood supply / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008863:Microspheres; D008875:Middle Aged; D061646:Operative Time; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: embolization; meningiomas; microspheres