Ophthalmic Artery Feeders in Meningioma Reduce the Effectiveness of Transarterial Embolization With n-Butyl Cyanoacrylate.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY World neurosurgery Pub Date : 2024-12-06 DOI:10.1016/j.wneu.2024.11.046
Tomofumi Takenaka, Takeo Nishida, Masatoshi Takagaki, Yoshiko Okita, Noriyuki Kijima, Ryuichi Hirayama, Yuichi Matsui, Shuhei Yamada, Tatsumaru Fukuda, Ryota Nakagawa, Takaki Matsumura, Hajime Nakamura, Naoki Kagawa, Haruhiko Kishima
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Abstract

Background: N-butyl cyanoacrylate (n-BCA) is often used for preoperative transarterial embolization (TAE) of meningiomas. However, factors affecting the embolization effect with n-BCA remain unclear. This study aimed to clarify the factors associated with the embolization rate after TAE using n-BCA in meningioma, from the aspect of feeder architecture.

Methods: We retrospectively analyzed 62 patients with meningioma who underwent preoperative TAE with n-BCA between 2016 and 2021. Patient variables, including characteristics, intraoperative findings, and outcomes, were collected. Feeder architecture was classified into 7 groups: 1) internal maxillary artery, 2) occipital artery, 3) ascending pharyngeal artery, 4) posterior meningeal artery, 5) infraclinoidal internal carotid artery, 6) ophthalmic artery (OphA), and 7) pial feeder group, based on preoperative angiography. We set primary outcome as the embolization rate, representing the reduction rate of the gadolinium-enhanced lesion volume observed on contrast-enhanced magnetic resonance imaging. Angiographic findings following n-BCA injection were classified as feeder occlusion or intratumoral embolization. We analyzed the factors associated with the embolization rate.

Results: The OphA feeder group showed a decrease in the embolization rate (P = 0.008). The number of feeder groups with intratumoral embolization showed a robust positive correlation (r = 0.557). The OphA feeder group showed an increase in the number of feeder groups (P < 0.001) and larger tumor volume (P = 0.005).

Conclusions: The OphA feeder group was associated with a lower embolization rate. Our study suggested that the vascular architecture in meningioma affected the efficacy of TAE with n-BCA.

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脑膜瘤中的眼动脉馈源降低了使用氰基丙烯酸正丁酯进行经动脉栓塞的效果。
背景和目的:N-丁基氰基丙烯酸酯(n-BCA)通常用于脑膜瘤的术前经动脉栓塞(TAE)。然而,影响 n-BCA 栓塞效果的因素仍不清楚。本研究旨在从馈线结构方面阐明脑膜瘤使用n-BCA进行TAE后栓塞率的相关因素:我们回顾性分析了 2016 年至 2021 年间接受 n-BCA 术前 TAE 的 62 例脑膜瘤患者。我们收集了患者的变量,包括特征、术中发现和结果。根据术前血管造影,将馈源结构分为七组:1)上颌内动脉;2)枕动脉;3)咽升动脉;4)脑膜后动脉;5)颈内动脉下段;6)眼动脉(OphA);7)髓馈源组。我们将主要结果设定为栓塞率,即造影剂增强磁共振成像观察到的钆增强病灶体积缩小率。注射 n-BCA 后的血管造影结果分为馈源闭塞(FO)和瘤内栓塞(IE)。我们分析了与栓塞率相关的因素:结果:OphA馈源组的栓塞率有所下降(P = 0.008)。馈源组的数量与 IE 呈显著正相关(r = 0.557)。OphA馈线组的馈线组数增加(P < 0.001),肿瘤体积增大(P = 0.005):结论:OphA馈源组的栓塞率较低。我们的研究表明,脑膜瘤的血管结构影响了n-BCA TAE的疗效。
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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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