• Gustavo Melo-Guzmán, Víctor Hugo Escobar-de la Garma, Felipe Padilla-Vázquez, Omar Antonio Pérez-Morales, and Rafael Mendizábal-Guerra.
• Servicio de Neurocirugía, Hospital Juárez de México, Secretaría de Salud, México DF, Mexico.
• Cir Cir. 2014 Jul 1;82(4):372-80.

BackgroundPreoperative embolization of hypervascular tumours such as meningiomas has proven to be a favorable factor for resection of the latter because it diminishes intraoperative bleeding and the need for blood transfusions.ObjectivesEvaluation of surgical outcomes of preoperative embolization with microspheres of giant supratentorial meningiomas.MethodsWe retrospectively analyzed patient records from 2007 to 2012 with the diagnosis of giant supratentorial meningiomas (> 5 cm) (n= 27) and obtained two samples: those with preoperative embolization (n= 14) and patients without any properative embolization (n= 13). We evaluated and compared statistically significant surgical bleeding, surgical time and resection grade (via Simpson scale). Additionally, we evaluated internal/external vascularization rate and the histopathologic diagnosis.ResultsAccording to the Simpson scale, the mean resection grade was 1.21 for embolized meningiomas, whereas for non-embolized meningiomas it was 1.92 . No differences were found in surgical bleeding and operative time. We used microspheres whose diameters were 40-120 μm, and these were easily observed with common microscopy techniques. In all cases we observed predominance in extracranial vascularization. No morbidity and mortality were recorded with the endovascular procedure.ConclusionsEmbolization with microspheres improves resection rate evaluated by the Simpson scale in patients with giant supratentorial meningiomas.

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