Vascular encasement score as a prognostic tool for outcome in skull base tumor resection
Objective - Involvement of major cerebral arteries in skull-base tumors poses a significant surgical challenge and is associated with increased peri- and postoperative complication rates. The aim of the current study is to introduce a vascular encasement score (VES) to assess intraoperative risk and...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
[13 August 2025]
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| In: |
World neurosurgery
Year: 2025, Volume: 202, Pages: 1-9 |
| ISSN: | 1878-8769 |
| DOI: | 10.1016/j.wneu.2025.124375 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.wneu.2025.124375 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1878875025007314 
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| Author Notes: | Iryna Bulakh, Robert Lucaciu, Nikola Duerr, Martin Scholz, Bogdana Suchorska |
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| 245 | 1 | 0 | |a Vascular encasement score as a prognostic tool for outcome in skull base tumor resection |c Iryna Bulakh, Robert Lucaciu, Nikola Duerr, Martin Scholz, Bogdana Suchorska |
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| 520 | |a Objective - Involvement of major cerebral arteries in skull-base tumors poses a significant surgical challenge and is associated with increased peri- and postoperative complication rates. The aim of the current study is to introduce a vascular encasement score (VES) to assess intraoperative risk and predict patient outcomes. - Methods - Patients undergoing surgery for skull base tumors involving at least one major cerebral artery between April 2019 and March 2022 were included. Tumor-vessel contact was assessed on preoperative magnetic resonance imaging, evaluating both the longitudinal and circumferential encasement of arteries. Each parameter was graded from 1 to 5. The VES was calculated by multiplying the summed grades of both dimensions. Neurological outcomes were dichotomized into “good” and “poor” and correlated with VES. - Results - Forty-eight patients were enrolled, most diagnosed with meningioma (79.17%). The mean resection rate was 77.23%, and the median VES was 32.5. Sixteen patients (33.3%) had poor outcomes. Higher VES scores were significantly associated with poor outcomes (P = 0.019). A receiver operating characteristic-derived threshold of 75 defined high-risk cases. Logistic regression confirmed that high VES (>75) predicted worse outcomes (P = 0.018). All patients with low VES had favorable outcomes and resection rates >90%. In contrast, 62.5% of patients with high VES had poor outcomes, influenced by a lower extent of resection (P < 0.001). - Conclusions - The magnetic resonance imaging-based VES provides a practical method to quantify vascular involvement in skull base tumors. It may support risk-adapted surgical planning and serve as a foundation for Artificial Intelligence-based tools enabling automated preoperative risk assessment. | ||
| 650 | 4 | |a Internal carotid artery | |
| 650 | 4 | |a Meningioma | |
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| 650 | 4 | |a Skull base | |
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| 700 | 1 | |a Suchorska, Bogdana |d 1983- |e VerfasserIn |0 (DE-588)140486887 |0 (DE-627)618899502 |0 (DE-576)318302624 |4 aut | |
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