2026 Proffered Presentations
S210: ENDOVASCULAR INTERVENTIONAL EMBOLIZATION WITH SUBSEQUENT MICROSURGERY FOR THE TREATMENT OF SOLID POSTERIOR FOSSA HEMANGIOBLASTOMAS: A RETROSPECTIVE COHORT STUDY
Liang Wang; Ziqi Liu; Lian Liu; Peiran Li; Kaibing Tian; Da Li; Junting Zhang; Liwei Zhang; Zhen Wu; Beijing Tiantan Hospital Affiliated to Capital Medical University
Background: Conventional surgical resection of solid posterior fossa hemangioblastomas (HBs) remains challenging due to high risks of intraoperative bleeding and normal perfusion pressure breakthrough (NPPB). This study reports a case series of endovascular interventional embolization with subsequent microsurgery for the treatment of solid posterior fossa HBs, aiming to advance clinical research on therapeutic strategies for these lesions.
Methods: 15 patients underwent endovascular interventional embolization combined with microsurgical resection of solid posterior fossa HBs from March 2021 to August 2024. Patient demographics, medical records and imaging files were reviewed, and follow-up clinical outcomes were investigated. The degree of devascularization in each patient was calculated quantitatively by using ImageJ software, and one-way repeated-measures ANOVA was used to compare the Karnofsky performance scale (KPS) score changes of patients.
Results: The 15 enrolled patients included six females (40.0%) and nine males (60.0%), with an average age of 37.5 years (range, 14.0-78.0 years). 11 cases (73.3%) involved tumors with extension to the medulla oblongata. The maximum tumor diameter ranged from 2.5 to 5.1 cm, with an average diameter of 3.6 cm. The degree of devascularization ranged from 40.1% to 94.2%, and the average was 71.7%. The average interval between embolization and resection was 5.0 days. Gross total resection was achieved in 15 patients (100%), with a median intraoperative blood loss of 300.0 ml (interquartile range, 300.0-600.0 ml). Notably, NPPB did not develop during or after microsurgery. The KPS scores of nine patients (60.0%) increased or remained unchanged discharge compared to their preoperative levels. The median follow-up was 28 months. At the last follow-up, most patients’ KPS scores (93.3%) improved.
Conclusion: Endovascular interventional embolization with subsequent microsurgery represents a safe and reasonable treatment strategy for solid posterior fossa hemangioblastomas. ImageJ-based quantification of embolization extent provides a valuable method for evaluating the degree of tumor devascularization.