INTRAOPERATIVE DOPPLER ULTRASOUND AS A DIAGNOSTIC TOOL FOR VASCULAR NAVIGATION IN BRAINSTEM TUMOR RESECTIONS juliopaza98@gmail.com

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INTRAOPERATIVE DOPPLER ULTRASOUND AS A DIAGNOSTIC TOOL FOR VASCULAR NAVIGATION IN BRAINSTEM TUMOR RESECTIONS

3

Mexico

Oral or Poster

Intraoperative ultrasound (IOUS) with Doppler overlay offers dynamic guidance for brainstem tumor resection yet large-scale outcome-based studies remain scarce. This study aimed to evaluate the impact of IOUS-Doppler on extent of resection, vascular complication rates, and intraoperative decision-making in brainstem tumor surgeries.

A retrospective cohort study of 104 consecutive patients (aged 6–68 years) who underwent microsurgical resection for intrinsic brainstem tumors at a tertiary neurosurgical center between January 2014 and December 2023. Patients receiving IOUS with Doppler overlay were compared to a historical cohort (n=90) treated without intraoperative Doppler assistance. Data on tumor type, extent of resection (MRI-confirmed), intraoperative changes, vascular injury, neurological deficits, and 30-day outcomes were analyzed. Statistical analysis used SPSS v29 with chi-square and t-tests; significance set at p<0.05.

The IOUS-Doppler group demonstrated a significantly higher rate of gross total resection (GTR) (60.5% vs. 45.2%, p = 0.008),with intraoperative trajectory modification performed in 45 of 104 patients (43.2%)based on Doppler vascular visualization.Vascular injury was significantly lower in the IOUS group (3.8% vs. 11.1%, p=0.027),and new postoperative neurological deficits were reduced (9.6% vs. 17.7%, p = 0.041).Mean operative duration was not significantly different between groups(230 ± 52 minutes vs. 238 ± 49 minutes, p = 0.24).No device-related failures or adverse ultrasound-related events were recorded.Hospital stay averaged 6.8 ± 2.3 days in the IOUS-Doppler group compared to 7.5 ± 2.6 days in the control group.

Intraoperative Doppler ultrasound enhances real-time vascular visualization, improving resection precision and safety in brainstem tumor surgery. Its cost-effectiveness supports use in resource-limited settings.