title: Embolisation of bone metastases from renal cancer.
abstract: OBJECTIVE
  This study was done to evaluate embolisation for palliative and/or adjuvant treatment of bone metastases from renal cell carcinoma and discuss the clinical and imaging results.
  
  
  METHODS
  We retrospectively studied 107 patients with bone metastases from renal cell carcinoma treated from December 2002 to January 2011 with 163 embolisations using N-2-butyl cyanoacrylate (NBCA). Mean tumour diameter before embolisation was 8.8 cm and mean follow-up 4 years. Clinical and imaging effects of treatment were evaluated at follow-up examinations with a pain score scale, analgesic use, hypoattenuating areas, tumour size and ossification.
  
  
  RESULTS
  A clinical response was achieved in 157 (96%) and no response in six embolisations of sacroiliac metastases. Mean duration of clinical response was 10 (range 1-12) months. Hypoattenuating areas resembling tumour necrosis were observed in all patients. Variable ossification appeared in 41 patients. Mean maximal tumour diameter after embolisation was 4.0 cm. One patient had intraprocedural tear of the left L3 artery and iliopsoas haemorrhage and was treated with occlusion of the bleeding vessel with NBCA. All patients had variable ischaemic pain that recovered completely within 2-4 days. Postembolisation syndrome was diagnosed after 15 embolisations (9.2%). Transient paraesthesias in the lower extremities were observed after 25 embolisations (25%) of pelvis and sacrum metastatic lesions.
  
  
  CONCLUSIONS
  Embolisation with NBCA is recommended as primary or palliative treatment of bone metastases from renal cell carcinoma. Strict adherence to the principles of transcatheter embolisation is important to avoid complications.
authors.affiliation: Department of Interventional Angiographic Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rossi
authors.forename: A F
authors.initials: AF
authors.lastname: Mavrogenis
authors.forename: R
authors.initials: R
authors.lastname: Casadei
authors.forename: G
authors.initials: G
authors.lastname: Bianchi
authors.forename: C
authors.initials: C
authors.lastname: Romagnoli
authors.forename: E
authors.initials: E
authors.lastname: Rimondi
authors.forename: P
authors.initials: P
authors.lastname: Ruggieri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007472:Iohexol / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D007472:Iohexol; D004998:Ethiodized Oil; D004659:Enbucrilate