Combined treatment of brain tumors in a multidisciplinary hospital. Examples of clinical cases
Abstract
In a multidisciplinary hospital, the combined treatment of profusely vascularized tumors is a justified means of preventing intra and postoperative complications, in particular bleeding. Preoperative embolization of cerebral arteries plays an important role as the first stage of surgical treatment. This procedure made it possible to facilitate the resection of the tumor and reduce the risk of intraoperative bleeding.
THE PURPOSE OF THE STUDY: to evaluate the effectiveness of preoperative embolization in patients with profusely vascularized brain tumors in a multidisciplinary hospital.
MATERIALS AND METHODS: On the basis of the N.V. Sklifosovsky Research Institute for Emergency medicine, 5 patients, taking into account the size of the meningioma, as well as its profusely vascularization according to cerebral angiography, underwent combined treatment in the form of microsurgical removal of a volume formation (meningioma) with preliminary endovascular shutdown of the branches of the external carotid artery feeding the tumor stroma.
RESULT: In 100 % of cases of combined treatment, there was minimal intraoperative bleeding. In the long-term period, an unfavorable outcome was not observed in these patients.
CONCLUSION: It is advisable to perform combined operations to remove profusely supplied, large and giant meningiomas in a multidisciplinary hospital, which has not only all modern neurosurgical equipment, but also an X-ray endovascular installation.
About the Authors
A. V. Prirodov
N. V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; Moscow State Medical University named after A. I. Evdokimov
Russian Federation
Russian Federation
Prirodov Alexander Vladislavovich
Moscow
R. M. Kozlova
N. V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation
Russian Federation
Kozlova Regina Maksimovna
Moscow
V. E. Ryabukhin
N. V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation
Russian Federation
Moscow
A. A. Grin
N. V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; N. V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; Moscow State Medical University named after A. I. Evdokimov
Russian Federation
Russian Federation
Grin Andrey Anatolievich
Moscow
References
1. Pprimary tumors of the central nervous system. Clinical recommendations. Moscow; 2019. accessed Feb 18, 2022. (In russ.). https://old.oncology-association.ru/files/ clinical-guidelines-2020/pervichnye_opuholi_CNS.pdf
2. Clinical recommendations on the use of intraoperative fluorescence diagnostics in surgery of brain tumors. Moscow; 2015. accessed Feb 18, 2022. (In russ.). https://www.nsi.ru/about/informatsiya-dlya-spetsialistov/neiroonkologiya/fluorescent_diagnostics.pdf
3. Svistov DV, Kandyba DV, Savello AV. preoperative embolization of extracranial and intracranial tumors. Neurosurgery. 2007;(2):24–37. (In russ.).
4. Hart JL, Davagnanam I, Chandrashekar HS, Brew S. Angiography and selective microcatheter embolization of a falcine meningioma supplied by the artery of davidoff and Schechter. j Neurosurg. 2011;114(3):710–713. https://doi.org/10.3171/2010.4.jNS 10218
5. Down CF, Van Halbach V, Higashida RT. Meningiomas: the role of preoperative angiography and embolization. Neurosurg Focus. 2003;15(1):1–4. https://doi.org/10.3171/foc.2003.15.1.10
6. Shah AH, Patel N, Raper dM, Bregy A, Ashour r, Elhammady MS, Aziz-Sultan Ma, Morcos JJ, Heros RC, Komotar RJ. The role of preoperative embolization for intracranial meningiomas. j Neurosurg. 2013;119(2):364–372. https://doi.org/10.3171/2013.3.jNS 121328
7. Brandel MG, Rennert RC, Wali AR, Santiago-Dieppa DR, Steinberg JA, Lopez Ramos C, Abraham P, Pannell JS, Khalessi AA. Impact of preoperative end-vascular embolization on immediate meningioma resection outcomes. Neurosurg Focus. 2018;44(4): e 6. https://doi.org/10.3171/2018.1.FoCUS17751
8. Kai Y, Hamada J, Morioka M, Yano S, Today T, Ushio y. Appropriate interval between embolization and surgery in patient with meningioma. ajNr am j Neuroradiol. 2002;23(1):139–142.
9. Hani U, Baig AN, Shamim MS, Salam B. role of preoperative embolization in management of central nervous system tumors. j pak Med assoc. 2021;71(1(А)):172–174.
10.
Review
For citations:
Prirodov A.V., Kozlova R.M., Ryabukhin V.E., Grin A.A. Combined treatment of brain tumors in a multidisciplinary hospital. Examples of clinical cases. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(2):117-121. (In Russ.)
Views:
57
Email this article 