• Pragyan Sarma, Ishita Pant, Manish Garg, and Anil Kumar Sharma.
• Department of Neurosurgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. Electronic address: pragyansarma@yahoo.com.
• World Neurosurg. 2022 Nov 1; 167: e1e9e1-e9.

BackgroundPreoperative embolization of intracranial meningiomas is an accepted treatment modality and offers many advantages for subsequent surgery. It has also been used as a primary therapy without subsequent surgery in selected cases. In this study, the authors share their experience of this procedure with minimal resources carried out in cases where definitive surgery was not advisable.MethodsThis is a prospective study of 6 cases of meningiomas treated over a period of 11 months (November 2020 to September 2021). None of the cases were fit for prolonged surgery under general anesthesia and also had certain comorbid conditions. Embolization was done in a setup with limited resources without a fully equipped catheterization lab. Post-procedure magnetic resonance imaging (MRI) was done within 48 hours of the procedure. Follow-up was done in the outpatient department.ResultsThere was complete disappearance of tumor blush in all the 6 cases. Immediate post-procedure MRI revealed significant necrosis of the tumor cavity. Three cases succumbed to their primary comorbid conditions and in the other cases follow-up was uneventful. Following embolization, clinical improvement of presenting symptoms was seen in all 6 cases.ConclusionsIn resource-restricted settings, by introducing such innovative methods it is possible to perform selected endovascular procedures. Embolization can be used as a primary treatment modality avoiding subsequent surgery in selected cases with a good outcome.Copyright © 2022 Elsevier Inc. All rights reserved.

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