Essibayi Muhammed Amir, Baker Amanda, Ryvlin Jessica, Pecorari Isabella, Fortunel Addison, Hamad Mousa, Khatri Deepak, Crisman Celina, Eskandar Emad N, Haranhalli Neil, Agarwal Vijay, Altschul David J
From the Department of Neurological Surgery (M.A.E, J.R., I.P., A.F., M.H., D.K., C.C., E.N.E., N.H., V.A., D.J.A.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
AJNR Am J Neuroradiol. 2025 Jun 3;46(6):1159-1165. doi: 10.3174/ajnr.A8624.
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 by using modern endovascular tools.
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.
Seven patients (median age 57 years; 6 men) underwent embolization for tumors located primarily at the planum sphenoidale (58%). Unilateral embolization was performed in most cases, with 1 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 mL. At a 9-month follow-up, the median mRS score was 1.
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.
前颅底脑膜瘤的术前栓塞可通过减少肿瘤血管供应来促进手术切除。然而，经眼动脉栓塞存在视觉并发症风险。本研究旨在利用现代血管内工具评估该技术的安全性和有效性。
这项回顾性研究纳入了2022年1月至2024年4月期间接受术前经眼动脉栓塞并随后进行手术切除的前颅底脑膜瘤患者。分析了患者的人口统计学资料、肿瘤特征、栓塞细节、手术结果和并发症。
7例患者（中位年龄57岁；6例男性）因主要位于蝶骨平台的肿瘤（58%）接受了栓塞。大多数情况下进行单侧栓塞，1例采用双侧经眼途径。常见的栓塞分支包括筛前动脉和筛后动脉。聚乙烯醇颗粒是主要栓塞剂（71%）。所有病例均实现血管造影去血管化且无并发症。71%的患者实现了全切，中位失血量为427毫升。在9个月的随访中，中位改良Rankin量表（mRS）评分为1分。
通过仔细的患者选择、先进的微导管技术和细致的操作，术前经眼动脉栓塞可安全进行以促进前颅底脑膜瘤的切除。这些结果表明，对于经验丰富的中心精心挑选的患者而言，这是一个可行选择，不过仍需要更大规模的前瞻性研究。
