Preoperative embolization of intracranial meningiomas with Embosphere microspheres.

BACKGROUND: To reduce intraoperative bleeding and to facilitate surgery by inducing tumor softening, a preoperative embolization of meningiomas is commonly recommended. PATIENTS AND METHODS: We report on our experience with non-resorbable microspheres (Embosphere) in the preoperative endovascular embolization of 17 intracranial meningiomas. After adding contrast media to the particles sized 40-500 micron, the embolization process was followed under fluoroscopy. There was a good passage of microcatheters if high concentrations of particles were avoided.
RESULTS: The obstruction of the tumor feeders by particles was accompanied by a regression of tumor blush in DSA. CT controls showed a diminished contrast accumulation of the tumors already 1-2 days after embolization. Histologically, Embosphere microspheres were easy detectable with all commonly used staining methods. Embolization triggered, microscopically detectable necrosis was found in 77 % of the tumors. The mean interval between embolization and tumor extirpation was 2.5 days. The average time required for tumor extirpation was 244 minutes, while the average blood loss was 749 ml.
CONCLUSIONS: Our experiences show that Embosphere microspheres are effective embolic agents in obstructing meningeal feeders of preoperatively treated meningiomas.