术前栓塞用作脑膜瘤手术切除的血管内辅助手段。然而，没有标准化的系统来评估栓塞过程中栓塞的功效或程度。我们试图建立一个纯粹的血管造影分级系统，以促进脑膜瘤栓塞结果的一致报告，并描述脑膜瘤的解剖学和其他特征，预测通过术前栓塞实现的断血管程度。我们确定了接受术前脑血管造影的脑膜瘤患者以及随后在 2015 年至 2021 年间进行的切除术。人口统计学、临床和影像数据均收集在研究登记处。我们定义血管造影断流分级标准如下：0级为无栓塞，1级为部分栓塞，2级为大部分栓塞，3级为颈外动脉完全栓塞，4级为完全栓塞。纳入了80名连续患者，其中60名患者接受了血管造影断流分级。术前肿瘤栓塞（20例进行血管造影，意图治疗但最终未栓塞）。栓塞肿瘤较大（59.0 vs 35.9 cc；P = .03）。各组之间的总切除率、住院时间和并发症发生率没有差异。动脉供血的分布在肿瘤之间以特定位置的方式存在显着差异。肿瘤位置和动脉供血来源均可预测栓塞程度。前中线脑膜瘤与颈内动脉（眼动脉、筛动脉）供应和较低的血管断流等级相关（P = .03）。由脑膜供血器（凸面、大脑镰、蝶骨翼）供血的肿瘤与较高的血管断流等级相关（P < .01）。肿瘤栓塞的手术并发症率为2.5%。血管造影结果可以分级以表明肿瘤栓塞的程度。该系统可以促进报告的血管造影结果的一致性。此外，动脉供血系统以肿瘤位置预测的方式变化，这些模式与这些肿瘤位置所实现的典型断血管程度相关。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 代表神经外科医生大会出版。

Preoperative embolization is used as an endovascular adjunct to surgical resection of meningiomas. However, there is no standardized system to assess the efficacy or extent of embolization during the embolization procedure. We sought to establish a purely angiographic grading system to facilitate consistent reporting of the outcome of meningioma embolization and to characterize the anatomic and other features of meningiomas that predict the degree of devascularization achieved through preoperative embolization.We identified patients with meningiomas who underwent preoperative cerebral angiography and subsequent resection between 2015 and 2021. Demographic, clinical, and imaging data were collected in a research registry. We defined an angiographic devascularization grading scale as follows: grade 0 for no embolization, 1 for partial embolization, 2 for majority embolization, 3 for complete external carotid artery embolization, and 4 for complete embolization.Eighty consecutive patients were included, 60 of whom underwent preoperative tumor embolization (20 underwent angiography with an intention to treat but ultimately not embolization). Embolized tumors were larger (59.0 vs 35.9 cc; P = .03). Gross total resection, length of stay, and complication rates did not differ among groups. The distribution of arterial feeders differed significantly across tumors in a location-specific manner. Both the tumor location and the identity of arterial feeders were predictive of the extent of embolization. Anterior midline meningiomas were associated with internal carotid (ophthalmic, ethmoidal) supply and lower devascularization grades (P = .03). Tumors fed by meningeal feeders (convexity, falcine, lateral sphenoid wing) were associated with higher devascularization grades (P < .01). The procedural complication rate for tumor embolization was 2.5%.Angiographic outcomes can be graded to indicate the extent of tumor embolization. This system may facilitate consistency of reported angiographic results. In addition, arterial feeders vary in a manner predicted by tumor location, and these patterns correlate with typical degrees of devascularization achieved in those tumor locations.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.