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Research ArticleNeurointervention

Efficacy of Trisacryl Gelatin Microspheres versus Polyvinyl Alcohol Particles in the Preoperative Embolization of Meningiomas

Martin Bendszus, Rüdiger Klein, Ralf Burger, Monika Warmuth-Metz, Erich Hofmann and Laszlo Solymosi
American Journal of Neuroradiology February 2000, 21 (2) 255-261;
Martin Bendszus
aFrom the Departments of Neuroradiology (M.B., M.W-M., E.H., L.S.), Neuropathology (R.K.), and Neurosurgery (R.B.), University of Würzburg, Germany.
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Rüdiger Klein
aFrom the Departments of Neuroradiology (M.B., M.W-M., E.H., L.S.), Neuropathology (R.K.), and Neurosurgery (R.B.), University of Würzburg, Germany.
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Ralf Burger
aFrom the Departments of Neuroradiology (M.B., M.W-M., E.H., L.S.), Neuropathology (R.K.), and Neurosurgery (R.B.), University of Würzburg, Germany.
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Monika Warmuth-Metz
aFrom the Departments of Neuroradiology (M.B., M.W-M., E.H., L.S.), Neuropathology (R.K.), and Neurosurgery (R.B.), University of Würzburg, Germany.
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Erich Hofmann
aFrom the Departments of Neuroradiology (M.B., M.W-M., E.H., L.S.), Neuropathology (R.K.), and Neurosurgery (R.B.), University of Würzburg, Germany.
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Laszlo Solymosi
aFrom the Departments of Neuroradiology (M.B., M.W-M., E.H., L.S.), Neuropathology (R.K.), and Neurosurgery (R.B.), University of Würzburg, Germany.
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    fig 1.

    Extent of angiographic preoperative devascularization in groups 1 through 3 (proportional representation for every group). White bars indicate trisacryl gelatin microspheres; dark gray bars, PVA particles 45 to 150 μm; light gray bars, PVA particles 150 to 250 μm

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    fig 2.

    Mean intraoperative blood loss (mL) and mean number of blood units in groups 1 through 3. Shaded bars indicate blood loss; black line, blood units

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    fig 3.

    Most distal intravascular location of the embolic agent in groups 1 through 3 (proportional representation for every group). White bars indicate trisacryl gelatin microspheres; light gray bars, PVA particles, 45 to 150 μm; dark gray bars, PVA particles 150 to 250 μm

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    fig 4.

    A, Low-power magnification of large PVA particles (150–250 μm) seen in arterial vessels of a meningioma. Note the particles in a small arterial vessel and large extent of necrosis next to the embolized vessel (original magnification ×60).

    B, High-power view shows the irregularly shaped large PVA particles that obliterate the lumen and lead to additional thrombosis (original magnification ×240).

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    fig 5.

    A, Small PVA particles (45–150 μm) are found in arterial vessel, in which they nearly completely obliterate the lumen, as well as in vessels in which they do not fully obliterate the lumen but lead to intravascular thrombosis (original magnification ×60).

    B, High-power view of small PVA particles in a precapillary vessel, with thrombosis surrounding the irregularly shaped PVA particle. A slight lymphocytic inflammatory reaction surrounds the vessel (original magnification ×480).

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    fig 6.

    A, Embospheres (100–300 μm) form rolls and aggregations but do not lead to thrombosis in larger vessels (original magnification ×60).

    B, High-power view of a single trisacryl gelatin microsphere that completely obliterates a precapillary vessel. A small capillary without blood particles branches from this embolized vessel (original magnification ×480).

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    TABLE 1:

    Data for patients treated with trisacryl gelatin microspheres

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    TABLE 2:

    Data for patients treated with polyvinyl alcohol particles (45–150 μm)

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    TABLE 3:

    Data for patients treated with polyvinyl alcohol particles (150–250 μm)

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American Journal of Neuroradiology
Vol. 21, Issue 2
1 Feb 2000
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Cite this article
Martin Bendszus, Rüdiger Klein, Ralf Burger, Monika Warmuth-Metz, Erich Hofmann, Laszlo Solymosi
Efficacy of Trisacryl Gelatin Microspheres versus Polyvinyl Alcohol Particles in the Preoperative Embolization of Meningiomas
American Journal of Neuroradiology Feb 2000, 21 (2) 255-261;

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Efficacy of Trisacryl Gelatin Microspheres versus Polyvinyl Alcohol Particles in the Preoperative Embolization of Meningiomas
Martin Bendszus, Rüdiger Klein, Ralf Burger, Monika Warmuth-Metz, Erich Hofmann, Laszlo Solymosi
American Journal of Neuroradiology Feb 2000, 21 (2) 255-261;
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