Preoperative transcatheter arterial embolization of hypervascular metastatic tumors of long bones.
BACKGROUND
Complete resection of hypervascular metastatic tumors is often complicated by massive intraoperative blood loss.


OBJECTIVE
To assess the technical success and clinical effectiveness of transcatheter arterial embolization (TAE) of hypervascular metastatic tumors of long bones to reduce blood loss during orthopedic surgery.


METHODS
From January 2000 to September 2009, 25 patients (M:F=13:12; mean age 58.3 years) were treated with TAE of metastatic bone tumors before elective, orthopedic surgery. In all cases, the indication for TAE was preoperative devascularization. Technical success, defined as obliteration of tumor staining to 70% or more, requirement for red blood cell transfusion within 24 h following surgery, and hematologic parameters, i.e. the hemoglobin, hematocrit, and erythrocyte counts before and after surgery, were obtained.


RESULTS
The technical success rate was 96% (24/25 patients). Gelatin sponge particles (n=21) or polyvinyl alcohol particles (n=4) were used as embolic materials. The mean amount of red blood cell transfusion within the 24 h following surgery was 1.91 units (range 0-6) in the 23 patients with technically successful TAE and who underwent surgery within 3 days after TAE. In 22 patients with technically successful TAE and available hematologic data, the mean gaps in the hemoglobin, hematocrit, and erythrocyte counts before and after operation were 1.22 g/dl, 4.07%, and 0.45 x 10(6)/mm(3), respectively.


CONCLUSIONS
Preoperative TAE is technically successful and clinically effective to minimize intraoperative and postoperative bleeding in patients with hypervascular metastasis to long bones.
Kwon
Jae Hyun
JH
Department of Radiology, Dongkuk University Hospital, Ilsan.
Shin
Ji Hoon
JH
Kim
Jin-Hyoung
JH
Gwon
Dong-Il
DI
Yoon
Hyun Ki
HK
Ko
Gi-Young
GY
Sung
Kyu Bo
KB
Song
Ho-Young
HY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001859:Bone Neoplasms / Q000098:blood supply / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000628:therapy*; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
D011142:Polyvinyl Alcohol