Purpose: To report the feasibility of using ethylene vinyl alcohol copolymer (EVAC) for embolization of lower-falx meningiomas.
Material and Methods: Three patients were treated. The procedures were done under general anesthesia. A terminal branch of the middle cerebral artery in the proximity of the tumor was catheterized as near as possible or into the pre-falcine arterial anastomotic network around the superior sagittal sinus, and embolization with EVAC was performed with a standard injection technique.
Results: This technique resulted in filling of the tumor-supplying dural arteries including all collaterals from both sides, filling of the dural territory of the tumor circulation, and some obliteration of the tumor's pial supply. On later operation, the tumors could be removed from the inside out with minimal brain retraction.
Conclusion: Effective preoperative embolization of lower-falx meningiomas using EVAC is feasible. This technique has a sound anatomical basis, and it can be used with benefit even in falx meningiomas with predominantly pial vascular supply.
