title: Long-term outcome of percutaneous alcohol embolization combined with percutaneous vertebroplasty in aggressive vertebral hemangiomas with epidural extension.
abstract: OBJECTIVE
  To evaluate, on a long-term basis, the safety and effectiveness of percutaneous alcohol embolization (PAE) combined with percutaneous vertebroplasty (PVP) as a sole treatment for aggressive vertebral haemangiomas (AVHs) with epidural extension.
  
  
  METHODS
  From 1996 to 2015, 26 consecutive patients (15 women [58%] and 11 men; mean age 51.8 years [range: 19-75 years]) underwent PAE combined with PVP (performed at day 15) for the treatment of 27 AVHs with epidural extension. Clinical outcome was evaluated with a mean delay of 88.3 ± 53.3 months (range: 22-217 months). The primary endpoint was pain relief evaluated with a visual analogue scale (VAS).
  
  
  RESULTS
  Pre-procedure mean VAS score was 7.23 ± 1.3 and significantly improved at last follow-up (m = 3.11 ± 1.9; p < 0.001). Ten patients (38.5%) remained asymptomatic. Eighty-eight percent of the patients with neurosensory disorders had complete regression of these symptoms. Two of the three patients with motor deficit did not show any improvement. No major complication was recorded.
  
  
  CONCLUSIONS
  PAE combined with PVP is a minimally invasive safe and effective therapeutic approach for AVH with epidural involvement, even on long-term clinical outcome. This technique appears mainly effective for pain and neurosensory symptoms, but seems less effective for motor deficit relief.
  
  
  CONCLUSIONS
  • Combination of PAE with PVP is a safe technique. • PAE combined with PVP is an effective treatment for sensory symptoms. • This strategy seems less effective in patients with motor deficits.
authors.affiliation: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Kévin
authors.initials: K
authors.lastname: Premat
authors.affiliation: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France. fredclare5@gmail.com.|Paris VI University Pierre et Marie Curie, Paris, France. fredclare5@gmail.com.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Clarençon
authors.affiliation: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Évelyne
authors.initials: É
authors.lastname: Cormier
authors.affiliation: Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Jugurtha
authors.initials: J
authors.lastname: Mahtout
authors.affiliation: Department of Orthopaedic Surgery, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Bonaccorsi
authors.affiliation: Paris VI University Pierre et Marie Curie, Paris, France.|Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Degos
authors.affiliation: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.|Paris VI University Pierre et Marie Curie, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Chiras
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D015174:Epidural Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D013904:Thoracic Vertebrae; D013997:Time Factors; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D055815:Young Adult
chemical_list: D000431:Ethanol
keywords: Alcohol embolization; Cementoplasty; Intraosseous haemangioma; Percutaneous; Vertebral