雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Preoperative Embolization for Meningiomas Using PVA Particles and Small Strips of Gelfoam Akira KURATA 1 , Hirotada SAEGUSA 1 , Taketomo OHMOMO 1 , Makoto TAKANO 1 , Yoshinori YAMAZAKI 1 , Kaichi TOKIWA 1 , Katumi IRIKURA 1 , Yoshio MIYASAKA 1 , Kenzo YADA 1 , Shinichi KAN 2 1Departments of Neurosurgery, Kitazato University School of Medicine 2Departments of Radiology, Kitazato University School of Medicine Keyword: Meningioma , Therapeutic embolization , PVA gelfoam pp.367-373
Published Date 1992/4/10
DOI https://doi.org/10.11477/mf.1436900431
  • Abstract
  • Look Inside

Preoperative embolization for highly vascularized and large meningiomas is an indispensable technique for facilitating their surgical removal by decreasing blood loss during the operation. This is a report of 4 large and highly vascularizecl meningiomas in the skull base, on which embolization of feeders was performed preoperatively by PVA (Polyvinyl alcohol foam) parti-cles (150-250 micron produced by INGENOR CO, Paris) and small strips of gelfoam (0.5×0.5×3-5mm). Under EEG monitoring, Isosorbide dinitrate was used for prevention and relief of vascular spasm. Lidocaine injection tests (Xylocaine 2%: 50mg mixed in equal volumes with Iopamiron 300) were performed for checking before embolization. In the intracranial por-tion, standard taper steerable guide wire was changed to seeker flexible soft-tip guide wire. In two cases, the meningioma was located in the medial part of the sphe-noidal ridge. In the other two cases, one meningioma was in the lateral part of the sphenoidal ridge and the other was in the olfactory groove. In all 4 cases, we successfully performed embolization without complica-tion. In one case, we had to perform embolization twice, because of revascularization detected by angiography 3 weeks after the first embolization. In this latter case, we had performed central embolization only, by using PVA particles, having left feeder with-out occlusion (peripheral embolization) using gelfoam. The result suggested that it was also necessary to per-form peripheral embolization especially if the tumor is fed by large tortuous and irregular abnormal vessels. Peripheral embolization may prevent PVA particles from washing out and causing progressive thrombosis by PVA particles. Gelfoam is a suitable material for bringing about peripheral embolization, because it is an absorbable agent and is safe. Total or nearly total re-section of meningiomas could be performed with mini-mum loss of blood in all 4 cases. In three of the cases, intraoperative blood transfusion was not necessary.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

関連文献

もっと見る

文献を共有