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<meta name="DC.Title" content="Appropriate Interval between Embolization and Surgery in Patients with Meningioma" />
<meta name="DC.Date" content="2002-01-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The best time for surgery after embolization of meningiomas remains unclear. We used the tumor-softening effect of embolization to determine this time.

METHODS: Forty-two patients with intracranial meningiomas that received more than 50% of their blood supply from the external carotid artery underwent embolization before surgery. The interval between embolization and surgery and the tumor consistency at the time of surgery were recorded. The interval between embolization and surgery was divided into 3-day segments, and an average tumor consistency score was obtained in segments. Patients were assigned to two groups: group 1 underwent surgery on a specified day after embolization; group 2 underwent surgery at a later date. We compared tumor consistency, blood loss, length of hospitalization, surgical resection time, Simpson grade at surgery, and complication rate in both groups.

RESULTS: On the polynomial regression curve, greatest tumor softening occurred 7–9 days after embolization. When the postembolization interval exceeded 10 days, no further softening occurred. Compared with group 1 patients, group 2 patients did not have an increased blood loss, a longer hospitalization, or a higher complication rate. In group 2, the surgical procedure required less time, and the Simpson grades were lower.

CONCLUSION: In meningiomas that receive more than 50% of their blood supply from the external carotid artery, the optimal interval between embolization and surgery is 7–9 days. This interval allows the greatest degree of tumor softening, which makes it possible to remove the tumor more safely and easily." />
<meta name="DC.Contributor" content="Yutaka Kai" />
<meta name="DC.Contributor" content="Jun-ichiro Hamada" />
<meta name="DC.Contributor" content="Motohiro Morioka" />
<meta name="DC.Contributor" content="Shigetoshi Yano" />
<meta name="DC.Contributor" content="Tatemi Todaka" />
<meta name="DC.Contributor" content="Yukitaka Ushio" />
<meta name="article:published_time" content="2002-01-01" />
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<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; The best time for surgery after embolization of meningiomas remains unclear. We used the tumor-softening effect of embolization to determine this time.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; Forty-two patients with intracranial meningiomas that received more than 50% of their blood supply from the external carotid artery underwent embolization before surgery. The interval between embolization and surgery and the tumor consistency at the time of surgery were recorded. The interval between embolization and surgery was divided into 3-day segments, and an average tumor consistency score was obtained in segments. Patients were assigned to two groups: group 1 underwent surgery on a specified day after embolization; group 2 underwent surgery at a later date. We compared tumor consistency, blood loss, length of hospitalization, surgical resection time, Simpson grade at surgery, and complication rate in both groups.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; On the polynomial regression curve, greatest tumor softening occurred 7–9 days after embolization. When the postembolization interval exceeded 10 days, no further softening occurred. Compared with group 1 patients, group 2 patients did not have an increased blood loss, a longer hospitalization, or a higher complication rate. In group 2, the surgical procedure required less time, and the Simpson grades were lower.&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; In meningiomas that receive more than 50% of their blood supply from the external carotid artery, the optimal interval between embolization and surgery is 7–9 days. This interval allows the greatest degree of tumor softening, which makes it possible to remove the tumor more safely and easily.&lt;/p&gt;" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The best time for surgery after embolization of meningiomas remains unclear. We used the tumor-softening effect of embolization to determine this time.

METHODS: Forty-two patients with intracranial meningiomas that received more than 50% of their blood supply from the external carotid artery underwent embolization before surgery. The interval between embolization and surgery and the tumor consistency at the time of surgery were recorded. The interval between embolization and surgery was divided into 3-day segments, and an average tumor consistency score was obtained in segments. Patients were assigned to two groups: group 1 underwent surgery on a specified day after embolization; group 2 underwent surgery at a later date. We compared tumor consistency, blood loss, length of hospitalization, surgical resection time, Simpson grade at surgery, and complication rate in both groups.

RESULTS: On the polynomial regression curve, greatest tumor softening occurred 7–9 days after embolization. When the postembolization interval exceeded 10 days, no further softening occurred. Compared with group 1 patients, group 2 patients did not have an increased blood loss, a longer hospitalization, or a higher complication rate. In group 2, the surgical procedure required less time, and the Simpson grades were lower.

CONCLUSION: In meningiomas that receive more than 50% of their blood supply from the external carotid artery, the optimal interval between embolization and surgery is 7–9 days. This interval allows the greatest degree of tumor softening, which makes it possible to remove the tumor more safely and easily." />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The best time for surgery after embolization of meningiomas remains unclear. We used the tumor-softening effect of embolization to determine this time.

METHODS: Forty-two patients with intracranial meningiomas that received more than 50% of their blood supply from the external carotid artery underwent embolization before surgery. The interval between embolization and surgery and the tumor consistency at the time of surgery were recorded. The interval between embolization and surgery was divided into 3-day segments, and an average tumor consistency score was obtained in segments. Patients were assigned to two groups: group 1 underwent surgery on a specified day after embolization; group 2 underwent surgery at a later date. We compared tumor consistency, blood loss, length of hospitalization, surgical resection time, Simpson grade at surgery, and complication rate in both groups.

RESULTS: On the polynomial regression curve, greatest tumor softening occurred 7–9 days after embolization. When the postembolization interval exceeded 10 days, no further softening occurred. Compared with group 1 patients, group 2 patients did not have an increased blood loss, a longer hospitalization, or a higher complication rate. In group 2, the surgical procedure required less time, and the Simpson grades were lower.

CONCLUSION: In meningiomas that receive more than 50% of their blood supply from the external carotid artery, the optimal interval between embolization and surgery is 7–9 days. This interval allows the greatest degree of tumor softening, which makes it possible to remove the tumor more safely and easily." />
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.1"><div class="cit-metadata"><cite>Hieshima GB, Everhart FR, Mehringer CM, et al. <strong>Preoperative embolization of meningiomas.</strong> <span class="cit-source">Surg Neurol</span> <span class="cit-pub-date">1980</span>;<span class="cit-vol">14</span>:<span class="cit-fpage">119</span>–127</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=7414494&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F1%2F139.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2 in text" id="ref-2">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.2"><div class="cit-metadata"><cite>Koike T, Sasaki O, Tanaka R, Arai H. <strong>Long-term results in a case of meningioma treated by embolization alone: case report.</strong> <span class="cit-source">Neurologia Medico Chirurgica</span> <span class="cit-pub-date">1990</span>;<span class="cit-vol">30</span>:<span class="cit-fpage">173</span>–177</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3 in text" id="ref-3">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.3"><div class="cit-metadata"><cite>Ng HK, Poon WS, Goh K, Chan MS. <strong>Histopathology of post-embolized meningiomas.</strong> <span class="cit-source">Am J Surg Path</span> <span class="cit-pub-date">1996</span>;<span class="cit-vol">20</span>:<span class="cit-fpage">1224</span>–1230</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=8827029&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F1%2F139.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4 in text" id="ref-4">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.4"><div class="cit-metadata"><cite>Dean BL, Flom RA, Wallace RC, et al. <strong>Efficacy of endovascular treatment of meningiomas: evaluation with matched samples.</strong> <span class="cit-source">AJNR Am J Neuroradiol</span> <span class="cit-pub-date">1994</span>;<span class="cit-vol">15</span>:<span class="cit-fpage">1675</span>–1680</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIxNS85LzE2NzUiO3M6NDoiYXRvbSI7czoxOToiL2FqbnIvMjMvMS8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5 in text" id="ref-5">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.5"><div class="cit-metadata"><cite>Connors JJ III, Wojak JC. <span class="cit-source">Interventional Neuroradiology: Strategies and Practical Techniques.</span> Philadelphia, Pa: W.B. Saunders;<span class="cit-pub-date">1999</span>;<span class="cit-fpage">28</span></cite></div><div class="cit-extra"></div></div></li><li><div class="cit ref-cit ref-other no-rev-xref" id="cit-23.1.139.6"><div class="cit-metadata"><cite>Hamada J, Kai Y, Nagahiro S, Hashimoto N, Iwata H, Ushio Y. <strong>Embolization with cellulose porous beads, II: clinical trial.</strong> <span class="cit-source">AJNR Am J Neuroradiol</span> <span class="cit-pub-date">1996</span>;<span class="cit-vol">17</span>:<span class="cit-fpage">1901</span>–1906</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMDoiMTcvMTAvMTkwMSI7czo0OiJhdG9tIjtzOjE5OiIvYWpuci8yMy8xLzEzOS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7 in text" id="ref-7">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.7"><div class="cit-metadata"><cite>Hamada J, Ushio Y, Kazekawa K, Tsukahara T, Hashimoto N, Iwata H. <strong>Embolization with cellulose porous beads, I: an experimental study.</strong> <span class="cit-source">AJNR Am J Neuroradiol</span> <span class="cit-pub-date">1996</span>;<span class="cit-vol">17</span>:<span class="cit-fpage">1895</span>–1899</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMDoiMTcvMTAvMTg5NSI7czo0OiJhdG9tIjtzOjE5OiIvYWpuci8yMy8xLzEzOS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8 in text" id="ref-8">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.8"><div class="cit-metadata"><cite>Simoca I, Olarescu AA, Jipescu I, Lisievici M. <strong>Postoperative outcome of intracranial meningiomas: long-term prognosis.</strong> <span class="cit-source">Rom J Neurol Psychiatry</span> <span class="cit-pub-date">1994</span>;<span class="cit-vol">32</span>:<span class="cit-fpage">237</span>–251</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=7779743&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F1%2F139.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9 in text" id="ref-9">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.9"><div class="cit-metadata"><cite>Djindjian R, Merland JJ, Rey A, Thurel J, Houdart R. <strong>Super-selective arteriography of the external carotid artery. Importance of this new technic in neurological diagnosis and in embolization.</strong> <span class="cit-source">Neuro Chirurgie</span> <span class="cit-pub-date">1973</span>;<span class="cit-fpage">165</span>–171</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-10-1" title="View reference 10 in text" id="ref-10">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.10"><div class="cit-metadata"><cite>Brismar J, Conqvist S. <strong>Therapeutic embolization in the external carotid artery region.</strong> <span class="cit-source">Acta Radiol Diagn</span> <span class="cit-pub-date">1978</span>;<span class="cit-vol">19</span>:<span class="cit-fpage">715</span>–731</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-11-1" title="View reference 11 in text" id="ref-11">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.11"><div class="cit-metadata"><cite>Manelfe C, Lasjaunias P, Ruscalleda J. <strong>Preoperative embolization of intracranial meningiomas.</strong> <span class="cit-source">AJNR Am J Neuroradiol</span> <span class="cit-pub-date">1986</span>;<span class="cit-vol">7</span>:<span class="cit-fpage">963</span>–972</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo3OiI3LzUvOTYzIjtzOjQ6ImF0b20iO3M6MTk6Ii9ham5yLzIzLzEvMTM5LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-12-1" title="View reference 12 in text" id="ref-12">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.12"><div class="cit-metadata"><cite>Richter HP, Schachenmayr W. <strong>Preoperative embolization of intracranial meningiomas.</strong> <span class="cit-source">Neurosurgery</span> <span class="cit-pub-date">1983</span>;<span class="cit-vol">13</span>:<span class="cit-fpage">261</span>–268</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=6621840&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F1%2F139.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=A1983RE93000008&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-13-1" title="View reference 13 in text" id="ref-13">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.13"><div class="cit-metadata"><cite>Teasdale E, Patterson J, McLellan D, Macpherson P. <strong>Subselective preoperative embolization for meningiomas: a radiological and pathological assessment.</strong> <span class="cit-source">J Neurosurg</span> <span class="cit-pub-date">1984</span>;<span class="cit-vol">60</span>:<span class="cit-fpage">506</span>–511</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=6699694&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F1%2F139.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-14-1" title="View reference 14 in text" id="ref-14">↵</a><div class="cit ref-cit ref-other" id="cit-23.1.139.14"><div class="cit-metadata"><cite>Jungling FD, Wakhloo AK, Hennig J. <strong>In vivo proton spectroscopy of meningioma after preoperative embolization.</strong> <span class="cit-source">Magn Res Med</span> <span class="cit-pub-date">1993</span>;<span class="cit-vol">30</span>:<span class="cit-fpage">155</span>–160</cite></div><div class="cit-extra"><a 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cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div></div>  </div>

  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2002, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">23 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">139-142; </span></div>
  
  
  
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