Preoperative Embolization for Highly Vascular Brain Tumors

NCT07823985 | Not Yet Recruiting

• 1 other identifier: Embolization of Brain Tumors
• Study Type: interventional
• Target: 55
• Locations: 0 countries
• Sites: N/A

Brief Summary

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. 1.Pre-procedural neurological and diagnostic cross-sectional imaging (contrast-enhanced MRI or CT angiography).
2. 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. 3.Microsurgical tumor resection within 24 to 72 hours following the embolization procedure.

Conditions

Meningioma; Hemangioblastoma; Brain Metastases; Brain Neoplasms

Keywords

Preoperative Embolization; Endovascular Embolization; Tumor Devascularization; Digital Subtraction Angiography; Intraoperative Blood Loss; Interventional Neuroradiology; Microsurgical Resection

Outcome Measures

Primary Outcomes (1)

• Number of Participants Achieving Defined Grades of Tumor Devascularization

  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%).

  24 hours post-embolization

Study Arms (1)

Preoperative Embolization and Surgical Resection

EXPERIMENTAL

Participants undergo pre-procedural neurological and imaging assessment, followed by diagnostic digital subtraction angiography (DSA) to identify tumor-feeding vessels. Super-selective microcatheterization is performed to deliver embolic agents (polyvinyl alcohol \[PVA\] particles, Onyx, or microcoils) for tumor devascularization. Post-embolization devascularization is evaluated by repeat DSA/CT, followed by microsurgical tumor resection within 24 to 72 hours.

Procedure: Preoperative Endovascular Embolization

Interventions

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.

Preoperative Embolization and Surgical Resection

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Assiut University: lead

MeSH Terms

Conditions

Brain Neoplasms; Meningioma; Hemangioblastoma

Condition Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Resident of Diagnostic and Interventional Radiology

Study Record Dates

• First Submitted: September 11, 2026
• First Posted: September 17, 2026
• Study Start: October 1, 2026
• Primary Completion (Estimated): October 1, 2027
• Study Completion (Estimated): November 1, 2027
• Last Updated: September 17, 2026

Record last verified: 2026-09