Sacdalan Dennis Raymond L, Ignacio Orlando R, Ignacio Glenn Marc G
Vascular and Interventional Radiology Section, Department of Radiology, Philippine General Hospital, University of the Philippines Manila.
Acta Med Philipp. 2025 Apr 30;59(5):52-57. doi: 10.47895/amp.vi0.10066. eCollection 2025.
Meningiomas represent the most prevalent benign intracranial tumors, comprising 13-26% of primary intracranial neoplasms. These tumors derive their blood supply from both extracranial and intracranial circulation. Over recent decades, pre-operative embolization (POE) has emerged as a potential adjunctive therapy to surgery, aiming to reduce tumor vascularity. Our study seeks to explore the potential correlation between the extent of devascularization following POE of meningiomas and intraoperative blood loss.
This cross-sectional study involved nine meningioma patients at a tertiary hospital, involving chart review of patients across four years. These patients were referred for POE due to angiographic evidence of a hypervascular mass between January 2018 and January 2022. We collected demographic data, tumor characteristics (including location, size, and vascular supply), and intraoperative variables such as total operative time and blood loss. Statistical analyses aimed to uncover correlations between vascularization degree and various factors.
Our population consists predominantly of females (53.68%), with a mean age of 45.85 ± 13.65 years. Only one mortality was recorded (7.7%). Pre-operative embolization achieved devascularization in the majority (69.2%) of cases, with approximately two-thirds (66.7%) experiencing complete devascularization. Mean total operative time stood at 336.11 ± 301.88 minutes, with a mean post-operative blood loss of 985.56 ± 1013.72 milliliters. Additionally, for those with recorded recovery times, the mean recovery time was 14.32 ± 13.51 hours.Mortality rates showed no association with sex, devascularization status, or number of feeding vessel zones. Furthermore, the extent of devascularization did not correlate with age, sex, number of feeding vessel zones, post-operative blood loss, total operative time, or recovery time (p >0.05).
In summary, this study represents a significant endeavor to elucidate factors influencing meningioma outcomes following pre-operative embolization. Despite limitations regarding patient numbers, our study offers valuable insights into operative parameters and embolization considerations for future analyses in our tertiary center.
脑膜瘤是最常见的颅内良性肿瘤，占原发性颅内肿瘤的13%-26%。这些肿瘤的血液供应来自颅外和颅内循环。在最近几十年中，术前栓塞（POE）已成为一种潜在的手术辅助治疗方法，旨在减少肿瘤血管。我们的研究旨在探讨脑膜瘤POE后血管减少程度与术中失血量之间的潜在相关性。
这项横断面研究涉及一家三级医院的9例脑膜瘤患者，回顾了4年间患者的病历。这些患者在2018年1月至2022年1月期间因血管造影显示有高血运肿块而接受POE。我们收集了人口统计学数据、肿瘤特征（包括位置、大小和血管供应）以及术中变量，如总手术时间和失血量。统计分析旨在揭示血管化程度与各种因素之间的相关性。
我们的研究对象以女性为主（53.68%），平均年龄为45.85±13.65岁。仅记录到1例死亡（7.7%）。术前栓塞在大多数病例（69.2%）中实现了血管减少，约三分之二（66.7%）的病例实现了完全血管减少。平均总手术时间为336.11±301.88分钟，平均术后失血量为985.56±1013.72毫升。此外，对于记录了恢复时间的患者，平均恢复时间为14.32±13.51小时。死亡率与性别、血管减少状态或供血血管区域数量无关。此外，血管减少程度与年龄、性别、供血血管区域数量、术后失血量、总手术时间或恢复时间均无相关性（p>0.05）。
总之，本研究是阐明影响脑膜瘤术前栓塞后结局的因素的一项重要努力。尽管在患者数量方面存在局限性，但我们的研究为三级中心未来分析的手术参数和栓塞考虑提供了有价值的见解。
