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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1809356
Original Article

Embolization of Meningiomas with Ultralow Concentration N-Butyl 2-Cyanoacrylate

Shiko Shimada
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Takehiro Suyama
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Mayuko Miyata
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Natsumi Yamamura
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Katsuya Ueno
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Nobuaki Naito
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Haruna Isozaki
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Yi Li
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Junichi Takeda
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Kunikazu Yoshimura
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
,
Masahiro Nonaka
1   Department of Neurosurgery, Kansai Medical University, Osaka, Japan
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Abstract

Objective

Preoperative embolization of meningiomas with n-butyl 2-cyanoacrylate (NBCA) is problematic as its adhesive nature may force termination prior to achieving adequate embolization of intratumoral vessels. Herein, we report the use of ultralow concentration NBCA embolization to address this issue.

Materials and Methods

Seventeen patients with meningiomas underwent embolization with ultralow concentration NBCA. Twenty-four tumor-feeding vessels were embolized with 5% NBCA to allow infiltration of the intratumoral vessels. Overall, this method achieved a reduced operative time and blood loss during the resection as compared with those of the nonembolized group.

Results

Embolization was achieved in all patients at ultralow concentrations. Additionally, 20 vessels (83.3%) were embolized up to the intratumoral level. Warmed 5% NBCA aided in the embolization of intratumoral vessels. Embolization effectively controlled bleeding in all patients, while in 15 patients (88.2%), some form of tumor necrosis or softening was observed, predominantly in the area of dural attachment, demonstrating the efficacy of embolization in tumor removal. No embolization-related complications were observed. The mean operative time for resection was significantly different between the embolization (17 patients) and nonembolization (9 patients) groups (316 vs. 412 minutes, p = 0.0271). In these two groups, the mean blood loss was 349 versus 575 mL, the mean maximum tumor diameter was 56.8 versus 35.4 mm (p = 0.0089), and the mean age was 73.3 versus 72.3 years, respectively, with the significantly larger embolization group having shorter operation time and less blood loss.

Conclusion

Embolization of meningiomas with ultralow concentrations of NBCA can help to reach intratumoral vessels.

Keywords

embolization - intratumoral vessels - meningioma - N-butyl 2-cyanoacrylate - ultralow concentration

Ethical Approval

The study protocol was approved by the Ethics Committee of the Kansai Medical University (No. 2023093).




Publication History

Article published online:
02 June 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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