Combined Use of TruFill DCS Detachable Coil System and Guglielmi Detachable Coil for Embolization of Meningioma Fed by Branches of the Cavernous Internal Carotid Artery-Technical Case Report-

Abstract

A 57-year-old female presented with a left petroclival meningioma fed by the meningohypophyseal trunk of the internal carotid artery (ICA). The enlarged tentorial marginal artery and inferior hypophyseal artery were successfully embolized with the TruFill DCS Detachable Coil System through a 0.019-inch inner diameter microcatheter. Superselective catheterization into the dorsal meningeal artery could not be achieved with the same microcatheter, because the catheter tip was too large to pass into the vessel. Subsequently the feeding artery was successfully embolized with a Guglielmi detachable coil (GDC) through a 0.016-inch inner diameter microcatheter. The patient underwent surgery without blood loss on the day after embolization. Our subjective impression was that the TruFill DCS was softer and had less resistance during insertion, whereas the GDC could be delivered through a smaller caliber system for smaller vessels. Appropriate use of the TruFill DCS and GDCs can allow efficient embolization of the feeding branches of the ICA.

Preoperative Onyx Embolization of Meningiomas Fed by the Ophthalmic Artery: A Case Series

“…In these cases, hypervascularized tumors are often fed by internal carotid artery branches, such as the OPH. [2][3][4][5][12][13][14][15] In this situation, the benefits of preoperative embolization must be weighed against the risk of complications, as an inadvertent interruption of blood flow to the central retinal artery may lead to retinal ischemia and visual compromise. 1,8,[13][14][15][16] The preoperative embolization of meningiomas supplied by the OPH requires superselective catheterization and the most distal placement of the microcatheter as possible, aiming to protect the central retinal artery of any reflux.…”

Endovascular prelude for delicate meningeoma operation: A case report

“…Few decades ago, materials like gel foam, lyophilized duramater and several kinds of catheters were available (7, 8) for tumor embolization. Nowadays, new materials and techniques make tumor vessels' embolization relatively safe and reliable option in preoperative treatment (9,10,11,12). Intra-arterial perfusion MRI and a new imaging modality for identifying biomarkers can reveal perfusion status and extent of ischemia in embolized meningiomas, thus becoming new, very useful diagnostic tool in meningioma patients (13).…”

Balloon-assisted embolization of skull base meningioma with liquid embolic agent

“…4 For embolization of skull base meningiomas supplied by branches of the cavernous ICA, the use of particles 6,8 or coils has been reported. 7 The majority of authors remain conservative about using liquid embolic agents because of a possible risk of permanent cranial nerve injury if the agent reaches the vasa nervosum. 2 Aware of this potential hazard, and weighing the expected benefits of embolization of a 5-cm meningioma engulfing the ICA, we cautiously undertook this embolization.…”