{"title":"Volume Reduction Effect of Preoperative Embolization of Only the Feeding Arteries from the External Carotid Artery on Vestibular Schwannomas.","authors":"Hiroki Sakamoto, Takao Hashimoto, Yusuke Arai, Hirofumi Okada, Muneaki Kikuno, Michihiro Kohno","doi":"10.1016/j.wneu.2024.11.063","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although there are many reports on the efficacy of preoperative embolization for meningioma, such as a reduction in intraoperative blood loss, its efficacy for vestibular schwannoma remains unclear. Feeding arteries of vestibular schwannomas include branches from the anterior inferior cerebellar artery and internal carotid artery, in addition to the branches from the external carotid artery (ECA). However, it has been reported that the embolization of feeding arteries from the anterior inferior cerebellar artery and the internal carotid artery has a high risk of complications. Therefore, we retrospectively analyzed the effects of preoperative embolization of only the feeding arteries from the ECA for vestibular schwannomas, particularly regarding its volume reduction effect.</p><p><strong>Methods: </strong>Of the 805 patients with vestibular schwannoma who underwent tumor removal at our department between September 2013 and March 2022, a total of 15 patients who underwent preoperative embolization of only the feeding arteries from the ECA were analyzed. Tumor volume was measured based on contrast-enhanced T1-weighted imaging, and the effects of preoperative embolization on tumor volume reduction were analyzed.</p><p><strong>Results: </strong>Tumor volumes before and after embolization were 16.4 ± 9.2 mL and 14.1 ± 9.6 mL, respectively, indicating a volume reduction effect of 15.3 ± 10.3% (P < 0.001). The mean time from embolization to contrast-enhanced T1-weighted imaging was 5.1 ± 3.0 days.</p><p><strong>Conclusions: </strong>Preoperative embolization of only the feeding arteries from the ECA may be an effective adjunctive treatment for vestibular schwannomas, given the significant volume reduction effect achieved within several days after embolization, in addition to reducing intraoperative blood loss.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123480"},"PeriodicalIF":1.9000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.11.063","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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Abstract
Background: Although there are many reports on the efficacy of preoperative embolization for meningioma, such as a reduction in intraoperative blood loss, its efficacy for vestibular schwannoma remains unclear. Feeding arteries of vestibular schwannomas include branches from the anterior inferior cerebellar artery and internal carotid artery, in addition to the branches from the external carotid artery (ECA). However, it has been reported that the embolization of feeding arteries from the anterior inferior cerebellar artery and the internal carotid artery has a high risk of complications. Therefore, we retrospectively analyzed the effects of preoperative embolization of only the feeding arteries from the ECA for vestibular schwannomas, particularly regarding its volume reduction effect.
Methods: Of the 805 patients with vestibular schwannoma who underwent tumor removal at our department between September 2013 and March 2022, a total of 15 patients who underwent preoperative embolization of only the feeding arteries from the ECA were analyzed. Tumor volume was measured based on contrast-enhanced T1-weighted imaging, and the effects of preoperative embolization on tumor volume reduction were analyzed.
Results: Tumor volumes before and after embolization were 16.4 ± 9.2 mL and 14.1 ± 9.6 mL, respectively, indicating a volume reduction effect of 15.3 ± 10.3% (P < 0.001). The mean time from embolization to contrast-enhanced T1-weighted imaging was 5.1 ± 3.0 days.
Conclusions: Preoperative embolization of only the feeding arteries from the ECA may be an effective adjunctive treatment for vestibular schwannomas, given the significant volume reduction effect achieved within several days after embolization, in addition to reducing intraoperative blood loss.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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