Journal of cerebrovascular and endovascular neurosurgery · 2026
Hybrid treatment for cerebellar arteriovenous malformations: A preliminary descriptive study.
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Medina-Carrillo Óscar, López-Valdés Julio César, Ayala-Arcipreste Arturo, Mendizabal-Guerra Rafael, Soto-Barraza Julio César, Melo-Guzmán Gustavo
Аннотация
OBJECTIVE: To evaluate the impact of preoperative embolization on intraoperative blood loss and surgical duration in patients undergoing cerebellar intracranial arteriovenous malformation (AVM) resection (2011-2022).
METHODS: A descriptive, retrospective, preliminary study (n=10 with complete data) classified patients into a Hybrid group (embolization+surgery, n=8) and a Surgery-only group (n=2). Intergroup comparisons for surgical metrics used the Mann-Whitney U test.
RESULTS: The Hybrid group demonstrated significantly improved intraoperative metrics. This cohort showed a highly significant decrease in blood loss (437.14 cc vs. 3,400 cc; p=0.018) and a significant reduction in surgical time (325 minutes vs. 530 minutes; p=0.018). Functionally, the Hybrid group achieved excellent recovery (median modified Rankin Scale [mRS] 1 at 6 months) despite having worse baseline morbidity (median mRS 3 vs. 1.5). The study found no significant difference in mRS improvement between groups.
CONCLUSIONS: Preoperative embolization is associated with reduced blood loss and shorter surgical duration in cerebellar AVM resection. These findings support embolization as a valuable adjunctive therapy. The results provide strong preliminary evidence of efficacy and intraoperative safety, but validation in prospective studies with larger samples is required.
METHODS: A descriptive, retrospective, preliminary study (n=10 with complete data) classified patients into a Hybrid group (embolization+surgery, n=8) and a Surgery-only group (n=2). Intergroup comparisons for surgical metrics used the Mann-Whitney U test.
RESULTS: The Hybrid group demonstrated significantly improved intraoperative metrics. This cohort showed a highly significant decrease in blood loss (437.14 cc vs. 3,400 cc; p=0.018) and a significant reduction in surgical time (325 minutes vs. 530 minutes; p=0.018). Functionally, the Hybrid group achieved excellent recovery (median modified Rankin Scale [mRS] 1 at 6 months) despite having worse baseline morbidity (median mRS 3 vs. 1.5). The study found no significant difference in mRS improvement between groups.
CONCLUSIONS: Preoperative embolization is associated with reduced blood loss and shorter surgical duration in cerebellar AVM resection. These findings support embolization as a valuable adjunctive therapy. The results provide strong preliminary evidence of efficacy and intraoperative safety, but validation in prospective studies with larger samples is required.