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Pre-operative embolisation of internal carotid artery branches and pial vessels in hypervascular brain tumours

Authors
 Yoon YS  ;  Ahn JY  ;  Chang JH  ;  Cho JH  ;  Suh SH  ;  Lee BH  ;  Lee KS. 
Citation
 ACTA NEUROCHIRURGICA, Vol.150(5) : 447-452, 2008 
Journal Title
 ACTA NEUROCHIRURGICA 
ISSN
 0001-6268 
Issue Date
2008
MeSH
Adult ; Blood Loss, Surgical/prevention & control ; Brain Neoplasms/blood supply* ; Brain Neoplasms/diagnosis ; Brain Neoplasms/secondary ; Brain Neoplasms/therapy* ; Carcinoma, Hepatocellular/blood supply ; Carcinoma, Hepatocellular/secondary ; Carcinoma, Hepatocellular/therapy ; Carotid Artery, Internal* ; Cerebral Angiography ; Embolization, Therapeutic*/adverse effects ; Female ; Humans ; Liver Neoplasms/pathology ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms/blood supply ; Meningeal Neoplasms/therapy ; Meningioma/blood supply ; Meningioma/therapy ; Middle Aged ; Neurosurgical Procedures* ; Pia Mater/blood supply* ; Preoperative Care*
Keywords
Adult ; Blood Loss, Surgical/prevention & control ; Brain Neoplasms/blood supply* ; Brain Neoplasms/diagnosis ; Brain Neoplasms/secondary ; Brain Neoplasms/therapy* ; Carcinoma, Hepatocellular/blood supply ; Carcinoma, Hepatocellular/secondary ; Carcinoma, Hepatocellular/therapy ; Carotid Artery, Internal* ; Cerebral Angiography ; Embolization, Therapeutic*/adverse effects ; Female ; Humans ; Liver Neoplasms/pathology ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms/blood supply ; Meningeal Neoplasms/therapy ; Meningioma/blood supply ; Meningioma/therapy ; Middle Aged ; Neurosurgical Procedures* ; Pia Mater/blood supply* ; Preoperative Care*
Abstract
BACKGROUND: Pre-operative embolisation is an effective method used to reduce intra-operative bleeding and operative difficulty in hypervascular brain tumour surgery. However, embolisation of the internal carotid artery (ICA) and pial tumour feeding branches has certain limitations. METHODS: From March 2000 to November 2006, 8 patients underwent superselective embolisation for hypervascular brain tumour. Seven tumours were extra-axial (6 meningiomas, 1 solitary fibrous tumour) and 1 was intra-axial (metastatic hepatocellular carcinoma). RESULTS: In all patients, feeding vessels from ICA branches or pial arteries were successfully embolised using superselective microcatheterisation. A provocative test was applied in 4 patients who had tumours adjacent to the motor cortex. Angiographic devascularisation was slight to extensive. Mean devascularisation on post-embolisation MRI ranged from 40 to 80% (mean 63.8%). One patient (12.5%) suffered an embolisation-related complication (loss of choroidal brush), but was not clinically worse because of the pre-existing blindness. CONCLUSIONS: Superselective embolisation of ICA branches or pial vessels should be performed if several conditions are met, especially angiographic findings, pre-existing neurologic deficits, provocative test, and technical feasibility. If the ICA embolisation for hypervascular tumour is successfully achieved, the bleeding loss and operative risk can be reduced.
Full Text
http://link.springer.com/article/10.1007/s00701-008-1513-1
DOI
10.1007/s00701-008-1513-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Ahn, Jung Yong(안정용)
Yoon, Young Sul(윤영설)
Lee, Kyu Sung(이규성)
Chang, Jong Hee(장종희)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108173
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