RT Journal Article
SR Electronic
T1 Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP ajnr.A8624
DO 10.3174/ajnr.A8624
A1 Essibayi, Muhammed Amir
A1 Baker, Amanda
A1 Ryvlin, Jessica
A1 Pecorari, Isabella
A1 Fortunel, Addison
A1 Hamad, Mousa
A1 Khatri, Deepak
A1 Crisman, Celina
A1 Eskandar, Emad
A1 Haranhalli, Neil
A1 Agarwal, Vijay
A1 Altschul, David J
YR 2024
UL http://www.ajnr.org/content/early/2024/12/17/ajnr.A8624.abstract
AB BACKGROUND AND PURPOSE: Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.MATERIALS AND METHODS: This retrospective study included patients with anterior skull base meningiomas who underwent preoperative transophthalmic artery embolization followed by surgical resection between January 2022 and April 2024. Patient demographics, tumor characteristics, embolization details, surgical outcomes, and complications were analyzed.RESULTS: Seven patients (median age 57 years; 6 male) underwent embolization for tumors located primarily at the planum sphenoidale (58%). Unilateral embolization was performed in most cases, with one bilateral transophthalmic approach. Commonly embolized branches included the anterior and posterior ethmoidal arteries. Polyvinyl alcohol particles were the primary embolic agent (71%). Angiographic devascularization was achieved in all cases without complications. Gross total resection was achieved in 71%, with a median blood loss of 427 cc. At a 9-month follow-up, the median modified Rankin Scale score was 1.CONCLUSIONS: With careful patient selection, advanced microcatheter technology, and meticulous technique, preoperative transophthalmic artery embolization can be safely performed to facilitate resection of anterior skull base meningiomas. These results suggest it is a viable option for well-selected patients at experienced centers, though larger prospective studies are needed.ABBREVIATIONS: Fr = French (unit of measurement for catheter diameter); IQR = Interquartile range; IRB = Institutional Review Board; PVA = Polyvinyl alcohol; TOAE = Transophthalmic artery embolization; WHO = World Health Organization.