Preoperative embolization of skull base meningiomas: current indications, techniques, and pearls for complication avoidance

Nam Yoon, Aatman Shah, William T. Couldwell, M. Yashar S. Kalani, Min S. Park
2018 Neurosurgical Focus  
FOCUS Neurosurg Focus 44 (4):E5, 2018 ABBREVIATIONS AEA/PEAs = anterior and/or posterior ethmoidal arteries; AVM = arteriovenous malformation; CN = cranial nerve; ECA = external carotid artery; ICA = internal carotid artery; ILT = inferolateral trunk; IMA = internal maxillary artery; MHT = meningohypophyseal trunk; MMA = middle meningeal artery; NBCA = N-butyl cyanoacrylate; OphA = ophthalmic artery; PVA = polyvinyl alcohol; VA = vertebral artery. Skull base meningiomas are technically
more » ... echnically challenging tumors to treat because of their deep vascular supply that can preclude early devascularization during resection. Preoperative embolization of these arterial feeders is thought to decrease blood loss and facilitate resection; however, given the complex and varied anatomy of these skull base lesions, preoperative embolization is not without risk. It is essential for both endovascular and skull base neurosurgeons to understand these risks in light of the potential benefits. The authors review the vascular anatomy of skull base meningiomas, indications for preoperative devascularization, endovascular techniques, and published results regarding embolization of these lesions. https://thejns.org/doi/abs/
doi:10.3171/2018.1.focus17686 pmid:29606046 fatcat:zjjuixvau5b4jlyfk66hsdwoyi