Does preoperative embolization improve outcomes of meningioma resection? A systematic review and meta-analysis

AbstractCurrent evidence regarding the benefit of preoperative embolization (POE) of meningiomas is inconclusive. This systematic review and meta-analysis aims to evaluate the safety profile of the procedure and to compare outcomes in embolized versus non-embolized meningiomas. PubMed was queried for studies after January 1990 reporting outcomes of POE. Pertinent variables were extracted and synthesized from eligible articles. Heterogeneity was assessed usingI2, and random-effects model was employed to calculate pooled 95% CI effect sizes. Publication bias was assessed using funnel plots and Harbord ’s and Begg’s tests. Meta-analyses were used to assess estimated blood loss and operative duration (mean difference; MD), gross-total resection (odds ratio; OR), and postsurgical complications and postsurgical mortality (risk difference; RD). Thirty-four studies encompassing 1782 preoperatively embolized meningiomas were captured. The pooled immediate complication rate following embolization was 4.3% (34 studies,n = 1782). Although heterogeneity was moderate to high (I2 = 35-86%), meta-analyses showed no statistically significant differences in estimated blood loss (8 studies,n = 1050, MD = 13.9 cc, 95% CI = −101.3 to 129.1), operative duration (11 studies,n = 1887, MD = 2.4 min, 95% CI = −35.5 to 30.8), gross-total resection (6 studies,n = 1608, OR = 1.07, 95% CI = 0.8 –1.5), postsurgical complications (12 studies,n = 2060, RD = 0.01, 95% CI = −0.04 to 0.07), and post...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research