{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:35:07Z","timestamp":1784039707129,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pheochromocytoma and paraganglioma in children present significant intraoperative hemodynamic challenges during surgical resection due to catecholamine release. Preoperative tumor arterial embolization is used to reduce bleeding and stabilize hemodynamics, but its efficacy in pediatric patients remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study included 31 children (aged 3\u201318\u2009years) undergoing resection of pheochromocytoma or paraganglioma at Beijing Children's Hospital from January 2019 to June 2025. Patients were divided into embolization (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912) and control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) groups based on preoperative embolization. High\u2010risk subgroups were defined by tumor diameter\u2009\u2265\u200910\u2009cm or severe catecholamine\u2010related complications. The primary endpoint was intraoperative systolic blood pressure fluctuation amplitude.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The embolization group had larger tumors (6.8\u2009\u00b1\u20093.1 vs. 4.6\u2009\u00b1\u20091.8\u2009cm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) and more high\u2010risk patients (50% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Systolic blood pressure fluctuation amplitude was similar between groups (103.9\u2009\u00b1\u200934.6 vs. 115.2\u2009\u00b1\u200935.7\u2009mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.393). No differences were observed in blood loss, time, or area under the curve for systolic blood pressure\u2009&gt;\u2009160\u2009mmHg, or intensive care unit stay. Postoperative tumor necrosis was higher in the embolization group (66.7% vs. 10.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). One embolization\u2010related stress cardiomyopathy occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although preoperative tumor arterial embolization did not significantly reduce overall intraoperative blood loss or hemodynamic instability in the entire cohort, it appears to effectively mitigate risk in children with larger, more biochemically active tumors, resulting in outcomes comparable to lower\u2010risk cases managed without embolization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Editorial Comment<\/jats:title>\n                    <jats:p>This article presents single center perioperative experience with preoperative tumor embolization treatments for pediatric pheochromacytoma and paraganglioma cases, and this compared to cases where tumor embolization was not chosen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70172","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:13:47Z","timestamp":1765840427000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Tumor Arterial Embolization on Hemodynamics During Surgical Resection of Pheochromocytoma and Paraganglioma in Children"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7271-3433","authenticated-orcid":false,"given":"Zenghua","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Beijing Children's Hospital, National Center for Children's Health, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Beijing Children's Hospital, National Center for Children's Health, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxue","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Beijing Children's Hospital, National Center for Children's Health, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Beijing Children's Hospital, National Center for Children's Health, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Beijing Children's Hospital, National Center for Children's Health, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5851-6622","authenticated-orcid":false,"given":"Fang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Beijing Children's Hospital, National Center for Children's Health, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-20-0628"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-021-01150-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-024-01024-5"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08221-2"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-3829"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11378"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1951.01250030644004"},{"issue":"4","key":"e_1_2_11_10_1","first-page":"1480","article-title":"Factors Associated With Perioperative Morbidity and Mortality in Patients With Pheochromocytoma: Analysis of 165 Operations at a Single Center","volume":"86","author":"Plouin P. 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