Abstract

PREOPERATIVE ENDOVASCULAR MANAGEMENT FOR HYPERVASCULARISED INTRACRANIAL TUMORS
Speaker: Vladimir Piatykop
Author: Piatykop V.1, Kotlyarevskiy Y.2, Kutoviy I.1, Sergienko Y.1, Pshenichniy A.2, Naboychenko A.1
Affiliation: 1Neurosurgical Department, Kharkov National Medical University, 2Neurosurgical Department, Kharkov Regional Clinical Hospital, Kharkov, Ukraine
Session: E-Posters
Date: Thursday - October 25, 2012 08:30-18:30
Location: Exhibition Area
Topic: Vascular problems in tumour surgery
Background and aims: The problem of massive intrasurgical bleeding, surgical invasiveness, possibility of the most radical removal of meningeal and hypervascularised intracerebral tumors is still quite actual even in spite of contemporary technical achievements. Our aim was introduction and enhancement of interventional neuroradiology techniques in conjunction with classical neurosurgical skills in order to improve the efficiency of surgical treatment of patients with extensively perfused brain tumors.
Methods: Our team has performed 37 preoperative embolisations of cerebral tumors vasculature. Three groups were sorted out: I - 23 cases of tumors supplied form both external and internal carotid basins; II - 11 cases with isolated supply from external carotid artery; III - 3 patients with internal carotid artery supplied tumors.
Results: Primary evaluation was done immediately after embolisation by means of control carotid angiography. Estimated features were the following: visualization of the vasculature itself, stop-contrast sign at the supplying vessel and embolization presence at the tumor projection. By this method embolization was total at 62% of cases; at 30% of cases (both basins supply) most part of the vessels was disabled; and in cases of intracerebral tumors - 3 patients (8%) - embolization was sufficient (considering the risk of complications).
Conclusions: The described method allows to decrease intraoperative blood loss during the removal of intensively vascularised brain tumors (even in cases when ECA basin is embolised only) and enables to perform surgery more radically and less traumatically.