Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

Liu, Aihua; Peng, Tangming; Wu, Zhen; Xiao, Xinru; Jiang, Chuhan; Wu, Zhongxue; Li, Youxiang

doi:10.7314/apjcp.2013.14.9.5179

Cited by 19 publications

(27 citation statements)

References 18 publications

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“…In recent years, there have been several reports of presurgical embolization being performed in order to control bleeding during hemangioblastoma surgeries. [ 3 4 5 6 9 11 14 18 ] However, serious complications such as stroke, hemorrhage, and swelling have also been reported,[ 4 6 ] and therefore the procedure's utility has not been established.…”

Section: Discussionmentioning

confidence: 99%

“…The authors reported that the duration of surgery was shortened, and the amount of blood loss and subsequent need for transfused blood were decreased in the embolization group. [ 11 ] There are other studies reporting that fewer complications arose in cases where n-butyl-cyanoacrylate (NBCA) was used as the embolization material. [ 9 14 ] However, this can result in recanalization after embolization because a tumor can develop collateral circulation from other vessels that embolized.…”

Section: Discussionmentioning

confidence: 99%

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The usefulness of indocyanine green during surgery for hypervascular posterior fossa tumors

Shinya¹,

Nagamine²,

Sugawara³

et al. 2018

Surg Neurol Int

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Background:Cerebral hemangioblastomas are benign tumors with abundant blood flow that occur mainly in the posterior fossa. Tumor removal en bloc is important in surgical treatment because of the risk of bleeding; however, it is actually rather difficult in practice. Therefore, we propose a surgical strategy for visualizing hypervascular tumors of the posterior fossa utilizing indocyanine green (ICG).Case Description:Case 1 involved a 48-year-old male with a history of von Hippel–Lindau (VHL) disease. Magnetic resonance imaging (MRI) revealed a solid tumor measuring 3.0 cm in diameter in the right cerebellopontine angle. We performed surgery because the tumor was pressing against the brainstem. Surgery was performed via the posterior subtemporal transtentorial approach in order to visualize the feeding artery and draining vein intraoperatively. The vessels were confirmed by ICG and the tumor was removed en bloc. Case 2 involved a 30-year-old woman. Signs of increased intracranial pressure were noted, and an MRI revealed a solid tumor 3.5 cm in diameter in the left cerebellar hemisphere. Surgery was performed via the midline suboccipital approach. Similarly, we confirmed the vessels using ICG and the tumor was removed en bloc.Conclusions:For hypervascular tumors of the posterior fossa, preoperative image assessment is important. Furthermore, the use of ICG during surgery is advantageous for surgical strategies where the feeding arteries and draining veins exist superficially in the operative field and are therefore easier to remove en bloc.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The usefulness of indocyanine green during surgery for hypervascular posterior fossa tumors

Shinya¹,

Nagamine²,

Sugawara³

et al. 2018

Surg Neurol Int

View full text Add to dashboard Cite

show abstract

“…3 Liu et al in their series reported that massive intraoperative bleeding prevented complete resection in eight cases of the control group and that blood loss reached 3240mL in some cases. 9 These lesions are surgically challenging cases due totheir high vascularity and their vicinity to neural andvascular structures in the tight posterior fossa, thusmaking total and safe surgical removal diffi cult.Dealing with these lesions basically requires differentthinking. The surgeon has to circulate around thelesion to devascularize it 360˚before its removal.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have reported spontaneous hemorrhage in some cases. 2,9 Massive bleeding with major blood loss can occur during attempts at surgical resection, which resulted in aborting the procedure in many cases.…”

Section: Discussionmentioning

confidence: 99%

A Giant Solitary Solid Hemangioblastoma: A Case Report and Review of The Literature

Bhandari¹,

Sharma²,

Bista³

et al. 2017

Nep J Neurosci

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We present a case of solitary vascular tumor on posterior cranial fossa in a 15-year-old female who had a complaint of headache on/off for six months with associated dizziness, nausea, vomiting and vertigo. Well circumscribed solid vascular mass was localized on posterior fossa by computed tomography along with magnetic resonance imaging scan. Furthermore, the diagnosis was confirmed by surgical findings and histological examinations.Nepal Journal of Neuroscience, Vol. 14, No. 2, 2017 Page: 47-50

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“…[ 4 ] The treatment of choice is surgical resection with or without preoperative embolization, depending on the tumor size and the local vascular anatomy. [ 7 11 ] However, traditional embolization remains controversial due to its risks such as distal catheter tip entrapment, vascular injury during navigation or catheter withdrawal, and embolic agent migration to the adjacent normal vasculature. [ 12 ] Although experience using Onyx embolization material with both detachable and nondetachable catheter tips has been well reported in a variety of clinical circumstances, we describe to the best of our knowledge the first case of a presurgical embolization of an intra-axial tumor (i.e., a recurrent cerebellar hemangioblastoma) that uses a second-generation detachable-tip microcatheter and a nonadhesive liquid embolic agent and achieves a nearly complete angiographic obliteration and successful subsequent surgical resection without complications.…”

Section: Introductionmentioning

confidence: 99%

Advantages of using a detachable-tip microcatheter and liquid embolic agents in the preoperative embolization of a recurrent cerebellar hemangioblastoma: A case report

Yañez¹,

Cifuentes²,

Mejía³

et al. 2017

Surg Neurol Int

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Background:The preferred treatment for intracranial hemangioblastomas is surgical resection with or without preoperative embolization, however, embolization remains controversial due to risks such as distal tip entrapment, vascular injury during navigation, and embolic agent migration.Case Description:A 54-year-old woman was admitted for surgical resection and preoperative embolization of a cerebellar hemangioblastoma. Although experience using Onyx with detachable and nondetachable tip microcatheters has been well reported in a variety of clinical circumstances, we describe the first case of a presurgical embolization of an intra-axial tumor using a second-generation detachable-tip microcatheter and a nonadhesive liquid embolic agent. Following the procedure, a nearly complete angiographic obliteration was achieved, as well as a successful subsequent surgical resection.Conclusion:Preoperative embolization with detachable-tip microcatheters and liquid embolic agents should be taken into consideration when assessing patients with hemangioblastomas of the posterior fossa due to the reduced risks of cardiac arrest, hemorrhage, and death.

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Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

Cited by 19 publications

References 18 publications

The usefulness of indocyanine green during surgery for hypervascular posterior fossa tumors

The usefulness of indocyanine green during surgery for hypervascular posterior fossa tumors

A Giant Solitary Solid Hemangioblastoma: A Case Report and Review of The Literature

Advantages of using a detachable-tip microcatheter and liquid embolic agents in the preoperative embolization of a recurrent cerebellar hemangioblastoma: A case report

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