Evidence map›Paper›PMID 41689670›Full record

ArticleActa neurochirurgica2026

Preoperative embolization of feeding arteries in glioblastoma: Technical strategies and clinical utility.

Masashi Uchida, Hidemichi Ito, Yuichiro Kushiro, Gaku Hidaka, Sora Yazaki, Yasuyuki Yoshida, Hiroshi Takasuna, Takashi Matsumori, Ichiro Takumi, Hidetaka Onodera and 2 more

Abstract read
In one paragraph

Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Masashi UchidaDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan. m2uchida@marianna-u.ac.jp.
Hidemichi ItoDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Yuichiro KushiroDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Gaku HidakaDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Sora YazakiDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Yasuyuki YoshidaDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Hiroshi TakasunaDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Takashi MatsumoriDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Ichiro TakumiDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Hidetaka OnoderaDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Toshihiro UedaDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
Hidetoshi MurataDepartment of Neurosurgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan. hmurata@marianna-u.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaximal safe resection-balancing aggressive tumor removal with neurological preservation-is essential in glioblastoma surgery. Cerebral angiography enables identification of the dominant hemisphere, feeding arteries, and vessels crossing eloquent areas, thereby aiding intraoperative planning. Preoperative embolization of glioblastoma feeders may shorten operative time and reduce intraoperative bleeding, similar to its established role in extra-axial tumors. We hypothesized that embolization could serve not as a routine adjunct but as a targeted strategy for selected glioblastomas with deep-seated or hypervascular feeders that increase surgical complexity.

methodsBetween December 2023 and July 2025, 15 consecutive patients with glioblastoma underwent preoperative embolization under local anesthesia using a 3-Fr distal radial approach. Coils and n-butyl-2-cyanoacrylate (NBCA) were used as embolic materials. Cerebral angiography and the Wada test (intracarotid amobarbital procedure) were performed to evaluate vascular anatomy and hemispheric dominance.

resultsThe embolization procedure required a mean of 1 h 26 min. Microscope-assisted tumor resection averaged 3 h 1 min, with a mean blood loss of 389 mL. No neurological or ischemic complications occurred, and postoperative MRI confirmed the absence of new ischemic changes.

conclusionsPreoperative embolization of glioblastoma-feeding arteries may provide a clear and bloodless surgical field, enhances spatial orientation through radiopaque contrast marking, and facilitates precise intraoperative localization. By reducing intraoperative bleeding, surgical complexity, and anesthesia time, this selective technique may decrease the overall invasiveness of glioblastoma surgery. When performed via a minimally invasive distal radial approach, preoperative embolization is a safe, feasible, and practical adjunct that enhances the precision and efficiency of glioblastoma resection.

Indexed as

Brain NeoplasmsEmbolization, TherapeuticGlioblastomaPreoperative CareAdultAgedCerebral AngiographyFemaleHumansMaleMiddle AgedNeurosurgical ProceduresClinical utilityDistal radial approachGlioblastomaPreoperative embolizationTechnical strategies

Identifiers

PMID41689670
PMCPMC12909416

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.