Temporary bilateral external carotid artery clamping to reduce blood loss during removal of calvarial meningioma: a technical note

Abstract

Objective. Large calvarial lesions may bleed extensively during their removal. The main vascular supply to such lesions is from branches of the external carotid arteries (ECAs). Bilateral ECA embolisation has been described to reduce the vascularity, and therefore blood loss of such lesions during their surgical removal, but it is expensive and not easily available in developing countries. In addition, it is associated with significant morbidity.

Case report. A case of a large calvarial meningioma, extending across the midline is presented in which both external carotids were temporarily clamped to reduce blood loss. Blood loss was low and the complications of permanent occlusion of the arteries avoided.

Conclusion. This technique can be used for vascular calvarial lesions extending across the midline where embolisation is not feasible or has failed.

Key words:

• Meningioma
• external carotid artery
• embolisation
• calvarial tumours

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.