Pre-surgical embolization of intracranial meningioma with Onyx: A safety and efficacy study.


Journal

Journal of neuroradiology = Journal de neuroradiologie
ISSN: 0150-9861
Titre abrégé: J Neuroradiol
Pays: France
ID NLM: 7705086

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 27 01 2019
revised: 16 05 2019
accepted: 17 05 2019
pubmed: 24 6 2019
medline: 8 5 2021
entrez: 24 6 2019
Statut: ppublish

Résumé

Pre-surgical embolization of large intracranial meningioma has been demonstrated to decrease blood loss and to improve the resectability of the tumor. Few reports have evaluated the risk and benefits of using Onyx in this indication. The objective of our study was to assess the efficiency and safety of pre-surgical embolization in a consecutive series of intracranial meningioma using Onyx. We conducted a retrospective study of consecutive patients treated from 2010 to 2018 with pre-surgical embolization with Onyx for intracranial histologically-proven meningioma. Safety was evaluated by a report of the complications related to the procedure while efficacy was assessed on angiographic and histopathologic criteria. Forty-four meningioma in 44 patients treated with pre-surgical embolization were included in this study. Proximal artery occlusion was obtained in 97.6% (41/42) of the cases and good intra-tumoral penetration was achieved in 75.6% (31/41). Embolic agent inside blood vessels was identified in 63.5% (28/44) of cases. Embolization-induced necrosis was present in 79.6% (35/44) of cases. Six complications have been encountered (13.6%); 3 were stated as minor complications (6.8%) and 3 as major occurring in case of trans-ophthalmic route (6.8%). The present work is to date the largest study to evaluate intracranial meningioma embolization using Onyx. Onyx's allowed good intra-tumoral penetration and proximal artery occlusion in most cases but carries a higher risk of complication in case of ophthalmic supply.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
Pre-surgical embolization of large intracranial meningioma has been demonstrated to decrease blood loss and to improve the resectability of the tumor. Few reports have evaluated the risk and benefits of using Onyx in this indication. The objective of our study was to assess the efficiency and safety of pre-surgical embolization in a consecutive series of intracranial meningioma using Onyx.
MATERIALS AND METHODS METHODS
We conducted a retrospective study of consecutive patients treated from 2010 to 2018 with pre-surgical embolization with Onyx for intracranial histologically-proven meningioma. Safety was evaluated by a report of the complications related to the procedure while efficacy was assessed on angiographic and histopathologic criteria.
RESULTS RESULTS
Forty-four meningioma in 44 patients treated with pre-surgical embolization were included in this study. Proximal artery occlusion was obtained in 97.6% (41/42) of the cases and good intra-tumoral penetration was achieved in 75.6% (31/41). Embolic agent inside blood vessels was identified in 63.5% (28/44) of cases. Embolization-induced necrosis was present in 79.6% (35/44) of cases. Six complications have been encountered (13.6%); 3 were stated as minor complications (6.8%) and 3 as major occurring in case of trans-ophthalmic route (6.8%).
CONCLUSIONS CONCLUSIONS
The present work is to date the largest study to evaluate intracranial meningioma embolization using Onyx. Onyx's allowed good intra-tumoral penetration and proximal artery occlusion in most cases but carries a higher risk of complication in case of ophthalmic supply.

Identifiants

pubmed: 31229578
pii: S0150-9861(19)30118-X
doi: 10.1016/j.neurad.2019.05.012
pii:
doi:

Substances chimiques

Onyx copolymer 0
Polyvinyls 0
Dimethyl Sulfoxide YOW8V9698H

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

353-357

Informations de copyright

Copyright © 2019 Elsevier Masson SAS. All rights reserved.

Auteurs

Guillaume Friconnet (G)

Department of Radiology, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France. Electronic address: guillaume.friconnet@yahoo.fr.

Victor Hugo Espíndola Ala (VH)

Department of Radiology, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France.

Leslie Lemnos (L)

Department of Neurosurgery, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France.

Suzana Saleme (S)

Department of Radiology, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France.

Mathilde Duchesne (M)

Department of Pathology, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France.

Henri Salle (H)

Department of Neurosurgery, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France.

François Caire (F)

Department of Neurosurgery, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France.

Charbel Mounayer (C)

Department of Radiology, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France; CNRS, XLIM, UMR 7252, 87000 Limoges, France.

Aymeric Rouchaud (A)

Department of Radiology, Centre Hospitalier et Universitaire Dupuytren, 87000 Limoges, France; CNRS, XLIM, UMR 7252, 87000 Limoges, France.

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Classifications MeSH