Preoperative embolization of Intracranial meningioma with Histoacryl through Middle meningeal artery: The effect on intraoperative blood loss and complications related to the procedures.

Abstract

Introduction: This study aims to evaluate the effectiveness of preoperative embolization of intracranial meningioma using N-Butyl-2-Cyanoacrylate (Histoacryl) in reducing intraoperative blood loss and also to assess the complications related to this procedure.
Materials and methods: This is a single-centered retrospective cross-sectional study of 106 patients with histologically proven meningioma underwent open surgical resection in University Malaya Medical Centre (UMMC) from 1st of January 2010 till 31st of May 2020. Out of the 106 samples, 29 of them underwent Histoacryl embolization prior to the surgery and 77 of them were subjected to surgery without preoperative embolization. The demographic data, mean comparison and correlation testing were performed using Statistical Package for the Social Sciences(SPSS).
Result: The majority of patients were female gender (68%). Most of the tumour were WHO grade 1 meningioma (86%). 48% of patients in the embolized group were transfused. Female gender had a longer duration of operation (280min vs 234min) and required higher amount of blood transfusion (1.3pint vs 0.6pint) compared to male gender (P<0.05). No statistical significance was found in the mean intraoperative blood loss, duration of operation and amount of blood transfused between the embolized and non-embolized group (P>0.05). No statistical difference was observed in the mean intraoperative blood loss, duration of operation and amount of blood transfused in patient embolized with Histoacryl in comparison with non-Histoacryl group (P>0.05). No post-embolization complication encountered in our centre. The meningo-opthalmic branch is seen in 4% of our study population.
Conclusion: Preoperative embolization of meningioma is a safe procedure with careful patient selection. No significant difference is observed in the intraoperative blood loss, duration of operation and amount of blood transfused between the embolized and the non-embolized group. However, we find that female has a significant longer duration of operation and requires higher amount of blood transfusion.