Hybrid treatment for cerebellar arteriovenous malformations: A preliminary descriptive study

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).

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.

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.

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.