Skip to main content
  • The Role of Pre-operative Embolization for Intracranial Meningiomas: Lessons from a Contemporary Series

    Final Number:

    Daniel M. S. Raper MBBS; Fraser Henderson; Dale Ding MD; Kenneth C. Liu MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Preoperative embolization for intracranial meningiomas offers potential advantages for safer and more effective subsequent resection. However, this treatment strategy has not been examined in a large contemporary series.

    Methods: Retrospective review of patients undergoing intracranial meningioma resection at UVA Hospital 01/2009-12/2012. Comparisons were made for embolized vs non-embolized patients, including method of embolization, complications, operative blood loss, and tumor characteristics. Statistical analysis was performed using chi-square and Fisher’s exact tests.

    Results: 145 patients were included. Average age was 56.2, and 28% of patients were male. The mean maximal tumor diameter was 3.74 cm. Patients were referred for preoperative embolization in 47% of cases, and full embolization was achieved in 76.5% (in 22% embolization was not possible; partial embolization was achieved in 1.5%). 97% of embolized patients experienced no complications; there were one case of stroke (1.6%) and one episode of iodine allergy (1.6%). Embolization was achieved using PVA particles in 47%, PVA + gelfoam in 26%, and PVA + coils in 21%. The vessel embolized was most commonly the middle meningeal (70%), followed by occipital artery (8.6%). 33% of patients had more than one vessel embolized and 17% had bilateral embolizations. Among patients who were embolized, average EBL at surgery was 356 mL (range: 50-2250). The rates of GTR, STR and partial resection were 72%, 16% and 12% respectively. Among patients who did not receive embolization, average EBL was 277 mL (range: 50-1300). The rates of GTR, STR and partial resection were 81%, 11% and 8% respectively. There were no statistically significant differences in EBL or rate of GTR between patients who were or were not embolized.

    Conclusions: Preoperative embolization is a safe option for some intracranial meningiomas. Although embolization may make a subjective difference during operative resection, there was no difference in EBL or ability to achieve GTR in the present study. Embolization should be considered on a case-by-case basis depending on imaging characteristics, anatomical location and patient-specific factors.

    Patient Care: Characterize the risks and benefits of preoperative embolization for meningiomas.

    Learning Objectives: Understand the advantages and limitations of preoperative embolization for intracranial meningiomas


We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy