PREOPERATIVE EMBOLIZATION OF MENINGIOMAS FED BY OPHTHALMIC BRANCH ARTERIES

BACKGROUND The efficacy of preoperative embolization for hypervascular meningiomas mainly fed by the branches of the ophthalmic arteries was examined. CASES AND METHODS Five hypervascular meningiomas mainly fed by the branches of the ophthalmic arteries, four posterior ethmoidal arteries, one anterior fair artery, and one recurrent middle meningeal artery were embolized with Gelfoam powder, polyvinyl alcohol (PVA) pa rticles, and/or microcoils as a preoperative treatment using a microca theter. RESULTS Catheterization of the ophthalmic and tumor feeding ar tery was possible and feeding arteries and lesion embolization were ef fective to reduce the bleeding during surgery in all cases. In three c ases, visual acuity and visual field were preserved. However, in one c ase, visual acuity and visual field defect appeared due to the migrati on of Gelfoam powder (Upjohn, Kalamazoo, MI) into the retinal artery. In another case, the retinal artery was embolized with the feeding art eries since the patient was already blind. CONCLUSION Embolization of hypervascular meningioma feeding vessels arising from the ophthalmic a rtery is possible and effective with preservation of vision, if emboli c agents are injected gently enough not to reflux into the central ret inal artery.