Type:
Educational Exhibit
Keywords:
Pathology, Education and training, Cancer, Surgery, Embolisation, Arterial access, MR, CT-Angiography, Catheter arteriography, Oncology, Interventional vascular, CNS
Authors:
S. M. I. Y. Shalaby1, W. Shawaf2; 1Cairo, Ca/EG, 2Cairo/EG
DOI:
10.26044/ecr2019/C-0405
Background
Meningiomas are the most common benign intracranial neoplasm,
showing a prevalence of approximately 13% to 26% of adult intracranial tumors.[1]
Intracranial meningioma is a common pathology and,
therefore,
familiar to all neurosurgical units.
Surgical excision is the mainstream way of treatment.
Preoperative endovascular embolization is aimed primarily at reducing this vascularity via the dural arteries.
Though,
preoperative embolization of intracranial meningioma has been always controversial since it was first described.
With benefits as decreased blood loss and “softening of the tumor” during subsequent surgical resection.
However,
the actual benefits still unclear,
with the potential risks of an additional procedure along with the cost of embolization have limited its use to a small proportion of the meningiomas.
One of the reasons it’s still controversial as a treatment strategy is that it has not been examined in a large comparative series.[2]
Meningiomas are usually supplied by the middle meningeal,
accessory meningeal,
ascending pharyngeal,
or occipital branches of the external carotid artery (ECA),
which are easily accessible by selective microcatheterization.[3]