Document Detail

Complications of particle embolization of meningiomas: frequency, risk factors, and outcome.
MedLine Citation:
PMID:  19729535     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Particle embolization is widely used in the treatment of meningiomas. We assessed the frequency and outcome of complications of embolization of meningiomas and tried to identify risk factors. MATERIALS AND METHODS: Between 1994 and 2009, a total of 198 patients with 201 meningiomas underwent embolization. Indication for embolization was preoperative in 165 meningiomas and adjunctive to radiosurgery in 8. In the remaining 28 meningiomas, embolization was initially offered as a sole therapy. There were 128 women and 70 men with a mean age of 54.4 years (median age, 54 years; range, 15-90 years). Complications were defined as any neurologic deficit or death that occurred during or after embolization. Logistic regression was used to identify the following possible risk factors: age above median, female sex, tumor size above median, meningioma location in 5 categories, use of small particle size (45-150 microm), the presence of major peritumoral edema, and arterial supply in 3 categories. RESULTS: Complications occurred in 11 patients (5.6%; 95% confidence interval [CI], 3.0%-9.8%). Ten complications were hemorrhagic, and 1 was ischemic. Six of 10 patients with hemorrhagic complications underwent emergency surgery with removal of the hematoma and meningioma. Complications of embolization resulted in death in 2 and dependency in 5 patients (7/198, 3.5%; 95% CI, 1.6%-2.0%). The use of small particles (45-150 mum) was the only risk factor for complications (odds ratio [OR], 10.21; CI, 1.3-80.7; P = .028). CONCLUSIONS: In this series, particle embolization of meningiomas had a complication rate of 5.6%. We believe that the use of small polyvinyl alcohol (PVA) particles (45-150 microm) should be discouraged.
D F M Carli; M Sluzewski; G N Beute; W J van Rooij
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Publication Detail:
Type:  Journal Article     Date:  2009-09-03
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-15     Completed Date:  2010-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-4     Citation Subset:  IM    
Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands.
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MeSH Terms
Aged, 80 and over
Embolization, Therapeutic / adverse effects*
Meningioma / therapy*
Middle Aged
Risk Factors
Treatment Outcome
Young Adult

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