To explore the clinical effect and analyze the clinical characteristics of patients who has convex meningioma and used preoperative embolization of dural artery to assist the treatment.

The clinical data of 6 patients with convex meningiomas treated by preoperative embolization artery embolization, admitted to Neurosurgery Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from June to November 2020, were analyzed retrospectively, including feeding artery, embolic artery, degree of embolization, estimated blood loss during resection and modified Rankin scale (mRs) at discharge. The relevant data of patients with convex meningiomas with a diameter of more than 5 cm without preoperative embolization during the same period were collected as the control group. The intraoperative estimated bleeding volume and mRs score of the two groups were compared and analyzed.

In this group, multiple blood vessels participated in the blood supply. All patients underwent middle meningeal artery embolization and were treated with partial embolism, 1 patient underwent simultaneous embolization of superficial temporal artery at the same time. After embolization, the peritumoral edema was aggravated in 1 patient, epilepsy and decreased limb muscle strength in 1 patient, and muscle strength recovered after resection. There were no bleeding and infarction after embolization. The tumor size of preoperative embolization group and non embolization group were 61.0(51.0, 76.0) mm and 53.5(51.0, 59.8) mm respectively, the estimated blood loss of preoperative embolization group and non embolization group were 900.0(375.0, 1425.0) mL and 1000.0(675.0, 1225.0) mL respectively. There was no significant difference in tumor size and estimated bleeding between the two groups (P>0.05). There was no new neurological dysfunction in both groups at discharge.

Surgical resection of large convex meningioma with rich blood supply is a high-risk treatment. Preoperative embolization of the meningeal artery may be an effective way to reduce intraoperative blood loss. However, there is still a lack of good evaluation indicators.