Preoperative Meningioma Embolization Reduces Perioperative Blood Loss: A Multi-Center Retrospective Matched Case-Control Study

Authors

Fawaz Al-Mufti, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.Follow
Chirag D. Gandhi, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
William T. Couldwell, Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
Ilya Rybkin, School of Medicine, New York Medical College, Valhalla, NY, USA.
Hussam Abou-Al-Shaar, Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Vincent Dodson, Department of Neurosurgery, Rutgers University, New Jersey Medical School, 90 Bergen Street, Newark, NJ, USA.
Anubhav G. Amin, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
John V. Wainwright, Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
Eric Cohen, Department of Neurosurgery, Rutgers University, New Jersey Medical School, 90 Bergen Street, Newark, NJ, USA.
Meic H. Schmidt, Department of Neurosurgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, USA.
Chad Cole, Department of Neurosurgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, USA.
Christian A. Bowers, Department of Neurosurgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, USA.

Author Type(s)

Faculty, Student

Journal Title

British Journal of Neurosurgery

First Page

67

Last Page

70

Document Type

Article

Publication Date

2-1-2023

Department

Neurology

Second Department

Neurosurgery

Abstract

BACKGROUND AND PURPOSE: The utility of preoperative embolization remains controversial within the literature. Here, we evaluate whether preoperative meningioma embolization is effective in reducing intraoperative blood loss, safe to perform, and cost-effective when compared with surgical resection without preoperative embolization. METHODS: Twenty-nine patients with meningiomas were matched by tumor size and location to 29 control patients with meningiomas at another institution where preoperative embolization was not practiced. The variables evaluated were pre- and post-operative hemoglobin and hematocrit levels as a measure of operative blood loss and postoperative morbidity. The additional cost of undergoing angiography and embolization was calculated from hospital charges obtained from the billing department. RESULTS: The mean decrease in perioperative hemoglobin and hematocrit was 0.9 and 2.7, respectively, in the embolization group and 2.8 and 10.0, respectively, in the control group for a significant decrease in operative blood loss as measured by change in hematocrit and hemoglobin levels after surgery. There was no significant difference in operative blood loss when subdividing patients based on tumor location. There were no angiogram-related complications. Twenty-two of 29 patients (76%) underwent embolization of a feeding artery, whereas 7 patients underwent only a diagnostic angiogram. The mean additional charge per patient in the embolization group was $88,767. CONCLUSIONS: Preoperative embolization was safe and effective in reducing the overall perioperative blood loss in patients undergoing meningioma resection, as measured by the change in postoperative hemoglobin and hematocrit levels. However, the cost of embolization was significant.

Recommended Citation

Al-Mufti, F., Gandhi, C. D., Couldwell, W. T., Rybkin, I., Abou-Al-Shaar, H., Dodson, V., Amin, A. G., Wainwright, J. V., Cohen, E., Schmidt, M. H., Cole, C., & Bowers, C. A. (2023). Preoperative Meningioma Embolization Reduces Perioperative Blood Loss: A Multi-Center Retrospective Matched Case-Control Study. British Journal of Neurosurgery, 37 (1), 67-70. https://doi.org/10.1080/02688697.2021.1979191