The role of preoperative embolization in the treatment of intracranial meningiomas

The current level of development of neurooncology, as well as achievements in anesthesiology, have significantly improved the results of operations with hypervascular tumors of the brain, however, surgical treatment of intracranial meningiomas remains one of the most actual issues of neurosurgery to this day.

PURPOSE OF THE STUDY: was to assess the effect of embolization of the vascular network of the tumor on the results of surgical treatment of intracranial meningiomas.

MATERIALS AND METHODS: a retrospective follow-up was carried out on 54 patients with hypervascular intracranial meningiomas who underwent hospital treatment in the neurosurgical department of the Stavropol regional clinical hospital from 2019 to 2021. The first group included 30 patients who underwent preoperative embolization of the tumor vascular network. The second group consisted of 24 patients who underwent microsurgical removal without preoperative embolization.

RESULTS AND DISCUSSION: the analysis of the results of treatment of patients with and without the use of preoperative embolization of the tumor network revealed the following key patterns: in the group of patients with PE, the average volume of blood loss was 322.41 ± 122.90 ml, in contrast to the second group, where this indicator reached 545.83 ± 147.38 ml (Student’s t–criterion, p < 0.001). Statistically significant differences were found when evaluating the results of treatment of patients according to the Glasgow Outcome Scale (GOS): in patients who underwent preoperative embolization, the median GOS score was higher than in patients of the second group (the median in the first group was 5 points, and in the second — 4 points, respectively (Mann-Whitney U-test, p < 0.001)).

CONCLUSIONS: preoperative embolization of the vascular network is an effective addition to classical microsurgical resection, which significantly improves treatment results by significantly reducing intraoperative blood loss, reducing the frequency of blood transfusions, and thereby improves treatment outcomes in patients with hypervascular meningiomas.

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