Complications of Particle Embolization of Meningiomas: Frequency, Risk Factors, and ORIGINAL RESEARCH Outcome D.F.M. Carli BACKGROUND AND PURPOSE: Particle embolization is widely used in the treatment of meningiomas. We assessed the frequency and outcome of complications of embolization of meningiomas and tried M. Sluzewski to identify risk factors. G.N. Beute MATERIALS AND METHODS: Between 1994 and 2009, a total of 198 patients with 201 meningiomas W.J. van Rooij underwent embolization. Indication for embolization was preoperative in 165 meningiomas and ad- junctive to radiosurgery in 8. In the remaining 28 meningiomas, embolization was initially offered as a sole therapy. There were 128 women and 70 men with a mean age of 54.4 years (median age, 54 years; range, 15–90 years). Complications were defined as any neurologic deficit or death that occurred during or after embolization. Logistic regression was used to identify the following possible risk factors: age above median, female sex, tumor size above median, meningioma location in 5 categories, use of small particle size (45–150
m), the presence of major peritumoral edema, and arterial supply in 3 categories. RESULTS: Complications occurred in 11 patients (5.6%; 95% confidence interval [CI], 3.0%–9.8%). Ten complications were hemorrhagic, and 1 was ischemic. Six of 10 patients with hemorrhagic complications underwent emergency surgery with removal of the hematoma and meningioma. Com- plications of embolization resulted in death in 2 and dependency in 5 patients (7/198, 3.5%; 95% CI, 1.6%–2.0%). The use of small particles (45–150
m) was the only risk factor for complications (odds ratio...