Chemical embolization using conjugated estrogen - A clinical study of 40 cases

Y. Nagamine, J. Suzuki, Y. Shimizu, S. Fujiwara, A. Takahashi

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Abstract

For the treatment of dural arteriovenous malformation (AVM), meningioma and other external carotid lesions, a method of chemical embolization using a conjugated estrogen is reported. A total of 40 cases were treated, including 11 cases of dural AVM, 20 cases of meningioma and 9 other cases such as of skull tumor, aneurysmal bone cyst, nasopharyngeal tumor, traumatic AV fistula, scalp AVM and venous angioma of the scalp. The conjugated estrogen was administered continuously through a cannula inserted into the external carotid artery. For venous angioma of the scalp, it was injected directly into the lesion. Disappearance or reduction of the abnormal vasculature of the lesion and/or the feeding arteries was confirmed on angiograms in 9 of 11 cases (81.9%) of dural AVM, in 17 of 20 cases (85%) of meningioma and in all cases of other external carotid lesions. Diminution of enhancement on CT scan was obtained in 8 of 20 cases (40%) of meningioma and in 6 of 7 cases (85.7%) of other external carotid lesions. There has been no recurrence of the dural AVM as long as 10 years. Eighteen cases of meningioma were operated on, and in 16 cases the lesion was totally removed without massive hemorrhage. In 2 cases of skull tumor and a case of nasopharyngeal tumor as well, the lesions were totally removed. Complications in 40 cases were as follows: parotitis in 17 cases, liver dysfunction in 3 cases, and each of gynecomastia, facial palsy, trismus and convulsion in one case. All of them cleared up after the interruption or reduction of administration of the conjugated estrogen. Serious complications were not recognized. Advantages of chemical embolization and mechanism of action of the conjugated estrogen were discussed.

Original languageEnglish
Pages (from-to)503-510
Number of pages8
JournalNeurological Surgery
Volume15
Issue number5
Publication statusPublished - 1987

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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