Preoperative transarterial embolization of hypervascular vertebral tumor with permanent particles.
OBJECTIVE
To evaluate the safety and value of preoperative transarterial embolization of hypervascular vertebral tumors.


METHODS
Sixteen patients with hypervascular vertebral tumors underwent transarterial embolization before surgery. The lesions were located between the middle cervical and lower lumbar spine. Forty-one arteries were embolized with permanent particles injected through a microcatheter, including polyvinyl alcohol (PVA) particles (150 - 500 micro m) in 25 arteries and Dextran particles (150 - 350 micro m) in 16. Of these, 31 had pieces of gelatin sponge added for proximal pedicled embolization. The criteria for judging the effectiveness of embolization were completeness of tumor removal and estimated blood loss during surgery.


RESULTS
The particles were injected into the tumor feeders through superselection in 17 arteries or flow control in 24. Tumor embolization was defined as "total" in five patients, "nearly total" in eight, "subtotal" in two, and "partial" in another. There were no symptomatic complications associated with embolization. Tumors were entirely removed in all patients. The average estimated blood loss during surgery was 1510 ml (range of 200 - 6000 ml) for all 16 patients.


CONCLUSIONS
Preoperative embolization of hypervascular vertebral tumors is safe and effective. It can make complete resection of a tumor possible and can make a previously unresectable tumor resectable. Superselection or flow control is necessary to achieve effective devascularization and to avoid complications.
Shi
Haibin
H
Department of Radiology, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China. hbshi@public1.ptt.js.cn
Jin
Zhengshuai
Z
Suh
Dae Chul
DC
Lee
Ho Kyu
HK
Li
Linsun
L
D000293:Adolescent; D000328:Adult; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000601:surgery*