Cerebrovascular Neurosurgery(Hybrid and Neuroendovascular Surgery)

The Department of Neurosurgery at Tianjin Huanhu Hospital is a National Key Clinical Specialty and a leading center for the diagnosis, treatment, and quality control of cerebrovascular diseases in Tianjin. Supported by Tianjin’s National Demonstration Advanced Stroke Center, the department has established a large-scale, comprehensive surgical and endovascular system for the management of cerebrovascular diseases.

As one of the department’s core disciplines, Cerebrovascular Neurosurgery has developed a highly specialized team with expertise in both microsurgical and endovascular techniques. The program comprises five major subspecialties: Complex Skull Base and Cerebrovascular Surgery; Hybrid Surgery and Integrated Cerebrovascular–Cardiovascular Care; Aneurysms and Arteriovenous Malformations; Acute and Chronic Large-Vessel Occlusion; and Cerebral Venous and Venous Sinus Disorders. Together, these subspecialties provide comprehensive coverage of hemorrhagic and ischemic cerebrovascular diseases involving both intracranial and extracranial, arterial and venous, and acute and chronic conditions.

Complex Skull Base and Cerebrovascular Surgery

This subspecialty is led by Professor Xiaoguang Tong, a nationally recognized neurosurgeon. The team specializes in the microsurgical and endovascular treatment of complex skull base vascular lesions and posterior circulation cerebrovascular diseases.

With extensive expertise in advanced skull base surgical techniques, the team is able to manage deeply located and technically challenging vascular lesions involving the petroclival region, peribrainstem area, and other complex skull base locations, as well as skull base tumors with major vascular involvement. By integrating skull base approaches, cerebrovascular microsurgery, and endovascular techniques, the team provides individualized treatment strategies for some of the most challenging cerebrovascular conditions.

Hybrid Surgery and Integrated Cerebrovascular–Cardiovascular Care

Supported by a modern hybrid operating room equipped with advanced digital subtraction angiography (DSA), neuronavigation, and intraoperative neurophysiological monitoring, this subspecialty integrates the complementary strengths of microsurgery, endovascular intervention, and neuroendoscopy. This platform enables one-stop diagnosis, treatment, and immediate intraoperative assessment of therapeutic efficacy for complex cerebrovascular diseases.

For conditions that may be difficult to treat optimally with a single modality—such as complex intracranial aneurysms, dural arteriovenous fistulas, and chronic large-vessel occlusions—the team can employ combined open microsurgical and endovascular strategies within a single-stage hybrid procedure. This integrated approach is designed to achieve precise and minimally invasive treatment of complex cerebrovascular lesions.

As one of the teams in China to explore the integrated management of systemic vascular disease, the subspecialty has also established a multidisciplinary team involving cardiovascular surgery, anesthesiology, and critical care medicine, developing an integrated model for the coordinated management of patients with concomitant cerebrovascular and cardiovascular diseases.

Aneurysms and Arteriovenous Malformations

This subspecialty has comprehensive expertise in both open cerebrovascular microsurgery and endovascular treatment, allowing treatment strategies to be individualized according to each patient’s vascular anatomy, lesion characteristics, clinical condition, and therapeutic needs.

The team treats nearly 800 cases of hemorrhagic cerebrovascular disease annually, including intracranial aneurysms, cerebral arteriovenous malformations (AVMs), and dural arteriovenous fistulas (dAVFs). Particular expertise has been developed in the management of complex posterior circulation aneurysms, blood blister-like aneurysms, giant intracranial aneurysms, and high-grade cerebral arteriovenous malformations.

Through the complementary application of microsurgical and endovascular techniques, the subspecialty provides individualized treatment options for patients with both conventional and highly complex cerebrovascular lesions.

Acute and Chronic Large-Vessel Occlusion

As a core component of the hospital’s acute stroke emergency service, this subspecialty has established a comprehensive care pathway encompassing prehospital emergency care, an in-hospital fast-track stroke pathway, endovascular treatment, postoperative critical care, and long-term rehabilitation.

The team performs more than 1,000 emergency mechanical thrombectomy procedures annually for patients with acute ischemic stroke caused by large-vessel occlusion. The workflow from hospital arrival to arterial puncture is maintained at an advanced international level through continuous optimization of emergency stroke protocols and multidisciplinary coordination.

In addition to acute stroke intervention, the team also provides individualized evaluation and treatment for patients with chronic intracranial and extracranial large-vessel occlusive disease, forming an integrated system for the management of both acute and chronic cerebral ischemic disorders.

Cerebral Venous and Venous Sinus Disorders

This subspecialty represents one of the earliest dedicated teams in China specializing in cerebral venous and dural venous sinus disorders and has participated in the development of Chinese clinical guidelines for intracranial venous sinus diseases.

The team systematically evaluates and treats a broad spectrum of cerebral venous disorders, including cerebral venous sinus thrombosis (CVST), dural venous sinus stenosis, idiopathic intracranial hypertension (IIH), pulsatile tinnitus, and spontaneous intracranial hypotension.

A comprehensive range of treatment strategies is available, including standardized anticoagulation therapy, catheter-directed thrombolysis, mechanical thrombectomy, and dural venous sinus stenting, according to individual clinical indications. By extending the cerebrovascular treatment spectrum from the arterial to the venous system, the subspecialty has established a comprehensive diagnostic and therapeutic framework for cerebral venous diseases and has developed substantial expertise in the management of complex venous sinus disorders.

Through the integration of cerebrovascular microsurgery, neuroendovascular intervention, hybrid surgery, skull base techniques, neurocritical care, and multidisciplinary collaboration, Cerebrovascular Neurosurgery at Tianjin Huanhu Hospital provides comprehensive and individualized care across the full spectrum of cerebrovascular diseases. The program remains committed to advancing precision, minimally invasive, and multidisciplinary cerebrovascular treatment while continuously improving clinical outcomes for patients with complex cerebrovascular disorders.