A standard technique for removal of arteriovenous malformations is adaptable to some meningiomas. This consists of first clipping and dividing the feeding arteries, thereby allowing partial shrinkage of the tumor by drainage of blood contained in its vascular channels. Cleavage planes are then developed and the tumor removed in toto, with ligation and division of its draining veins at the very end. This obviates the need for the usual piecemeal removal and its attendant blood loss. This technique is not applicable to all meningiomas but only to those in which the feeding arteries can be localized in the preoperative angiograms. When applicable, it may be particularly helpful in poor-risk patients whose tolerance for blood loss is limited. Three such cases are presented, with good results.
Salibi BS, Reyes CN. Meningioma: Helpful Technique for Easier RemovalPreliminary Report. Arch Surg. 1970;101(4):539-540. doi:10.1001/archsurg.1970.01340280091025