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<meta name="DC.Title" content="Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8624" />
<meta name="DC.Date" content="2024-12-18" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.

MATERIALS AND METHODS: This retrospective study included patients with anterior skull base meningiomas who underwent preoperative transophthalmic artery embolization followed by surgical resection between January 2022 and April 2024. Patient demographics, tumor characteristics, embolization details, surgical outcomes, and complications were analyzed.

RESULTS: Seven patients (median age 57 years; 6 male) underwent embolization for tumors located primarily at the planum sphenoidale (58%). Unilateral embolization was performed in most cases, with one bilateral transophthalmic approach. Commonly embolized branches included the anterior and posterior ethmoidal arteries. Polyvinyl alcohol particles were the primary embolic agent (71%). Angiographic devascularization was achieved in all cases without complications. Gross total resection was achieved in 71%, with a median blood loss of 427 cc. At a 9-month follow-up, the median modified Rankin Scale score was 1.

CONCLUSIONS: With careful patient selection, advanced microcatheter technology, and meticulous technique, preoperative transophthalmic artery embolization can be safely performed to facilitate resection of anterior skull base meningiomas. These results suggest it is a viable option for well-selected patients at experienced centers, though larger prospective studies are needed.

ABBREVIATIONS: Fr = French (unit of measurement for catheter diameter); IQR = Interquartile range; IRB = Institutional Review Board; PVA = Polyvinyl alcohol; TOAE = Transophthalmic artery embolization; WHO = World Health Organization." />
<meta name="DC.Contributor" content="Muhammed Amir Essibayi" />
<meta name="DC.Contributor" content="Amanda Baker" />
<meta name="DC.Contributor" content="Jessica Ryvlin" />
<meta name="DC.Contributor" content="Isabella Pecorari" />
<meta name="DC.Contributor" content="Addison Fortunel" />
<meta name="DC.Contributor" content="Mousa Hamad" />
<meta name="DC.Contributor" content="Deepak Khatri" />
<meta name="DC.Contributor" content="Celina Crisman" />
<meta name="DC.Contributor" content="Emad Eskandar" />
<meta name="DC.Contributor" content="Neil Haranhalli" />
<meta name="DC.Contributor" content="Vijay Agarwal" />
<meta name="DC.Contributor" content="David J Altschul" />
<meta name="article:published_time" content="2024-12-17" />
<meta name="article:section" content="ORIGINAL RESEARCH" />
<meta name="citation_title" content="Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;ABSTRACT&lt;/h3&gt;
&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;This retrospective study included patients with anterior skull base meningiomas who underwent preoperative transophthalmic artery embolization followed by surgical resection between January 2022 and April 2024. Patient demographics, tumor characteristics, embolization details, surgical outcomes, and complications were analyzed.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Seven patients (median age 57 years; 6 male) underwent embolization for tumors located primarily at the planum sphenoidale (58%). Unilateral embolization was performed in most cases, with one bilateral transophthalmic approach. Commonly embolized branches included the anterior and posterior ethmoidal arteries. Polyvinyl alcohol particles were the primary embolic agent (71%). Angiographic devascularization was achieved in all cases without complications. Gross total resection was achieved in 71%, with a median blood loss of 427 cc. At a 9-month follow-up, the median modified Rankin Scale score was 1.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;With careful patient selection, advanced microcatheter technology, and meticulous technique, preoperative transophthalmic artery embolization can be safely performed to facilitate resection of anterior skull base meningiomas. These results suggest it is a viable option for well-selected patients at experienced centers, though larger prospective studies are needed.&lt;/p&gt;&lt;p&gt;ABBREVIATIONS: Fr = French (unit of measurement for catheter diameter); IQR = Interquartile range; IRB = Institutional Review Board; PVA = Polyvinyl alcohol; TOAE = Transophthalmic artery embolization; WHO = World Health Organization.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2024/12/17" />
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<meta name="citation_author" content="Muhammed Amir Essibayi" />
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<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
<meta name="citation_author" content="Jessica Ryvlin" />
<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
<meta name="citation_author" content="Isabella Pecorari" />
<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
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<meta name="citation_author" content="Mousa Hamad" />
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<meta name="citation_author" content="Deepak Khatri" />
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<meta name="citation_author" content="Celina Crisman" />
<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
<meta name="citation_author" content="Emad Eskandar" />
<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
<meta name="citation_author" content="Neil Haranhalli" />
<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
<meta name="citation_author" content="Vijay Agarwal" />
<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
<meta name="citation_author" content="David J Altschul" />
<meta name="citation_author_institution" content="From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA." />
<meta name="twitter:title" content="Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.

MATERIALS AND METHODS: This retrospective study included patients with anterior skull base meningiomas who underwent preoperative transophthalmic artery embolization followed by surgical resection between January 2022 and April 2024. Patient demographics, tumor characteristics, embolization details, surgical outcomes, and complications were analyzed.

RESULTS: Seven patients (median age 57 years; 6 male) underwent embolization for tumors located primarily at the planum sphenoidale (58%). Unilateral embolization was performed in most cases, with one bilateral transophthalmic approach. Commonly embolized branches included the anterior and posterior ethmoidal arteries. Polyvinyl alcohol particles were the primary embolic agent (71%). Angiographic devascularization was achieved in all cases without complications. Gross total resection was achieved in 71%, with a median blood loss of 427 cc. At a 9-month follow-up, the median modified Rankin Scale score was 1.

CONCLUSIONS: With careful patient selection, advanced microcatheter technology, and meticulous technique, preoperative transophthalmic artery embolization can be safely performed to facilitate resection of anterior skull base meningiomas. These results suggest it is a viable option for well-selected patients at experienced centers, though larger prospective studies are needed.

ABBREVIATIONS: Fr = French (unit of measurement for catheter diameter); IQR = Interquartile range; IRB = Institutional Review Board; PVA = Polyvinyl alcohol; TOAE = Transophthalmic artery embolization; WHO = World Health Organization." />
<meta name="og-title" property="og:title" content="Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2024/12/17/ajnr.A8624" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.

MATERIALS AND METHODS: This retrospective study included patients with anterior skull base meningiomas who underwent preoperative transophthalmic artery embolization followed by surgical resection between January 2022 and April 2024. Patient demographics, tumor characteristics, embolization details, surgical outcomes, and complications were analyzed.

RESULTS: Seven patients (median age 57 years; 6 male) underwent embolization for tumors located primarily at the planum sphenoidale (58%). Unilateral embolization was performed in most cases, with one bilateral transophthalmic approach. Commonly embolized branches included the anterior and posterior ethmoidal arteries. Polyvinyl alcohol particles were the primary embolic agent (71%). Angiographic devascularization was achieved in all cases without complications. Gross total resection was achieved in 71%, with a median blood loss of 427 cc. At a 9-month follow-up, the median modified Rankin Scale score was 1.

CONCLUSIONS: With careful patient selection, advanced microcatheter technology, and meticulous technique, preoperative transophthalmic artery embolization can be safely performed to facilitate resection of anterior skull base meningiomas. These results suggest it is a viable option for well-selected patients at experienced centers, though larger prospective studies are needed.

ABBREVIATIONS: Fr = French (unit of measurement for catheter diameter); IQR = Interquartile range; IRB = Institutional Review Board; PVA = Polyvinyl alcohol; TOAE = Transophthalmic artery embolization; WHO = World Health Organization." />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node112388--5" data-node-nid="112388" id="top-node-112388--6490593323" data-pisa="ajnr;ajnr.A8624v1" data-pisa-master="ajnr;ajnr.A8624" data-apath="/ajnr/early/2024/12/17/ajnr.A8624.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">ORIGINAL RESEARCH</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Muhammed Amir Essibayi</span>, <span class="highwire-citation-author" data-delta="1">Amanda Baker</span>, <span class="highwire-citation-author" data-delta="2">Jessica Ryvlin</span>, <span class="highwire-citation-author" data-delta="3">Isabella Pecorari</span>, <span class="highwire-citation-author" data-delta="4">Addison Fortunel</span>, <span class="highwire-citation-author" data-delta="5">Mousa Hamad</span>, <span class="highwire-citation-author" data-delta="6">Deepak Khatri</span>, <span class="highwire-citation-author" data-delta="7">Celina Crisman</span>, <span class="highwire-citation-author" data-delta="8">Emad Eskandar</span>, <span class="highwire-citation-author" data-delta="9">Neil Haranhalli</span>, <span class="highwire-citation-author" data-delta="10">Vijay Agarwal</span> and <span class="highwire-citation-author" data-delta="11">David J Altschul</span></span></div>
  
    	<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">December 2024,  </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">ajnr.A8624; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8624 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-112388--6490593323" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Muhammed Amir Essibayi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Muhammed%2BAmir%2BEssibayi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Essibayi%20MA&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AMuhammed%2BAmir%2BEssibayi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Amanda Baker </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Amanda%2BBaker%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Baker%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AAmanda%2BBaker%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Jessica Ryvlin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Jessica%2BRyvlin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ryvlin%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJessica%2BRyvlin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Isabella Pecorari </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Isabella%2BPecorari%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pecorari%20I&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li 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author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fortunel%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AAddison%2BFortunel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Mousa Hamad </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.</div></span></div><ul 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M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Deepak%2BKhatri%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Khatri%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ADeepak%2BKhatri%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div 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