術前塞栓術

Preoperative Embolization for Cerebellopontine Angle Tumors

Point

・術前塞栓術は脳腫瘍摘出術の前処置としての位置付けであることを念頭に置き，安全に行う意識が重要である．

・小脳橋角部腫瘍の術前塞栓術ではvasa nervorum（神経栄養血管）が絡むことが多く，注意が必要である．

・Embosphere^®（Merit Medical Systems）500〜700μmと大きめなサイズを使用し希釈率を上げることで，安全かつ効果的な塞栓術が可能である．

　Preoperative embolization of brain tumors has been reported to be useful in reducing blood loss during resection, softening the tumor, and shortening the operation time by occluding blood-rich tumor nutrient vessels. This applies to skull base tumors, which are deep and difficult to expand in the operative field. Cerebellopontine angle tumors often have the petrosal branch of the middle dural artery, ascending pharyngeal artery, meningohypophyseal trunk, and inferolateral trunk as feeding vessels. Caution is required because these blood vessels are involved in the vasa nervorum and dangerous anastomosis. Embolization of these vessels can be performed safely and effectively by guiding a small catheter as far as possible to the periphery without wedging and injecting a high dilution of Embosphere^® 500-700μm.