Usefulness of Preoperative Transarterial Feeder Embolization of Cerebellar Hemangioblastomas

Abstract

Objective: Preoperative transarterial feeder embolization (TAE) may contribute to the safe surgical removal of hyper­ vascular tumors such as cerebellar hemangioblastomas (CHBs). We examined the usefulness of preoperative TAE of CHBs in our series. Methods: We retrospectively analyzed the results of treatment in seven patients with CHBs who had undergone preoperative TAE and subsequent surgery in our hospital between 2005 and 2015 (four males and three females, mean age: 45 years). Results: The embolized feeders consisted of the posterior inferior cerebellar artery in five patients, superior cerebellar artery (SCA) in one patient, and occipital artery (OA) in one patient. The embolic materials consisted of polyvinyl alcohol (PVA) in two patients, n­butyl­2­cyanoacrylate (NBCA) in four patients, and the combination of PVA and NBCA in one patient. Surgery was performed 1–4 days after embolization. The mean volume of intraoperative blood loss was 593 mL. In all patients, total surgical removal of the tumor was possible in the absence of non­autologous blood transfusion. Furthermore, embolic blood vessels could be identified during surgery in all patients, contributing to intraoperative orientation. Periprocedural complication related to TAE, cerebellar infarction related to embolic­material migration into a normal blood vessel occurred in one patient (13%). Conclusion: The results suggest that preoperative TAE of CHBs using NBCA contributes to a decrease in the volume of intraoperative blood loss, intraoperative orientation, and safe surgical removal of CHBs.