Preoperative Embolization for Highly Vascular Brain Tumors

Highly vascular brain tumors, including meningiomas, hemangioblastomas, and certain metastases, have a rich blood supply that can lead to substantial blood loss and technical difficulties during surgical removal. Preoperative endovascular embolization is an adjunctive, catheter-based procedure used to block the feeding blood vessels of the tumor before surgery, aiming to reduce intraoperative bleeding and facilitate safer tumor resection.

The primary purpose of this study is to evaluate the technical feasibility, safety, and effectiveness of preoperative endovascular embolization in patients with highly vascular intracranial tumors.

Participants enrolled in this prospective study will undergo:

1. Pre-procedural neurological and diagnostic cross-sectional imaging (contrast-enhanced MRI or CT angiography). 2. Diagnostic digital subtraction angiography (DSA) to map tumor-feeding arteries, followed by super-selective catheterization to deliver embolic materials (polyvinyl alcohol particles, Onyx, or microcoils). 3. Microsurgical tumor resection within 24 to 72 hours following the embolization procedure.

Researchers will assess the degree of tumor devascularization achieved, the volume of intraoperative blood loss, blood transfusion requirements, total surgical duration, extent of tumor resection, and the occurrence of any procedure-related complications.

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Key information

Conditions

Brain Neoplasms Brain Diseases Brain Metastases Central Nervous System Diseases Central Nervous System Neoplasms Hemangioblastoma Hemangioma Hemangioma, Capillary Meningeal Neoplasms Meningioma Neoplasms Neoplasms by Histologic Type Neoplasms by Site Neoplasms, Nerve Tissue Neoplasms, Vascular Tissue Nervous System Diseases Nervous System Neoplasms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Diagnosis of a hypervascular brain tumor (e.g., meningioma, hemangioblastoma, or hypervascular metastasis) confirmed by contrast-enhanced MRI or CT
Scheduled for preoperative endovascular embolization followed by microsurgical resection

Exclusion criteria

Severe, uncorrected coagulopathy
Severe allergy to iodinated contrast media
Severe renal insufficiency (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m²)
Absence of safe arterial access
Absence of identifiable tumor-feeding vessels suitable for selective microcatheterization

Treatment and study plan

Preoperative Endovascular Embolization

Procedure

Diagnostic cerebral digital subtraction angiography (DSA) is performed to identify tumor-feeding arteries and exclude dangerous anastomoses. Super-selective microcatheterization is then conducted to deliver embolic materials (polyvinyl alcohol [PVA] particles, Onyx, or microcoils) directly into the tumor vasculature. Tumor devascularization is quantified via post-procedural DSA/CT (<50%, 50-80%, or >80%). Following endovascular devascularization, patients undergo microsurgical tumor resection within 24 to 72 hours.

Primary outcomes

Number of Participants Achieving Defined Grades of Tumor Devascularization

Time frame: 24 hours post-embolization

Tumor devascularization is determined by comparing post-embolization digital subtraction angiography (DSA) or CT angiography against baseline diagnostic imaging. Participants are categorized into three predefined grades based on devascularization of tumor vascular blush: poor (<50%), moderate (50% to 80%), or good/complete (>80%).

Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

Preoperative Embolization for Highly Vascularised Intracranial Tumors

Important dates

Study start: 2026
Primary completion: 2027
Study completion: 2027
First posted: Sep 17, 2026
Registry last updated: Sep 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed