Preoperative transarterial embolization of vertebral metastases.

Détails

ID Serval
serval:BIB_3F8728876520
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Preoperative transarterial embolization of vertebral metastases.
Périodique
European Spine Journal
Auteur(s)
Guzman R., Dubach-Schwizer S., Heini P., Lovblad K.O., Kalbermatten D., Schroth G., Remonda L.
ISSN
0940-6719
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
14
Numéro
3
Pages
263-268
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article - Publication Status: ppublish
Résumé
The aim of this study was to evaluate the impact of preoperative devascularization of spinal metastases in relation to the preembolization tumor vascularization degree and in relation to the intraoperative blood loss. Twenty-four patients underwent preoperative transarterial embolization of hypervascular spinal metastases. Each tumor was assigned a vascularization grade (I-III) according to tumor blush after contrast agent injection in the main feeding artery. Embolization was performed with polyvinyl alcohol particles in all patients. Surgical reports were reviewed in terms of estimated blood loss. A mild hypervascularization was found in three patients (group I), medium in six patients (group II) and extensive in 15 patients (group III). In 22 out of 24 patients embolization could be performed with a complete devascularization. In two patients, only partial embolization could be performed, due to the main feeding artery arising from the artery of Adamkiewicz. In patients with complete devascularization the mean intraoperative blood loss was 1,900 ml, whereas in the two patients who were not embolized it was 5,500 ml. Intraoperative blood loss was not correlated to the vascularization grade. Angiography and embolization could be performed in all patients without causing permanent neurologic deficit, skin or muscle necrosis. The surgeons concluded that radical tumor resection after embolization was facilitated. Intraoperative blood loss is not correlated with the pre-interventional vascularization degree, if complete devascularization can be achieved with embolization. Preoperative embolization of vertebral hypervascular tumors is safe, effective and facilitates tumor resection.
Mots-clé
Adult, Aged, Aged, 80 and over, Aorta, Abdominal/drug effects, Cohort Studies, Combined Modality Therapy, Embolization, Therapeutic/methods, Female, Follow-Up Studies, Humans, Lumbar Vertebrae/blood supply, Lumbar Vertebrae/pathology, Magnetic Resonance Angiography, Male, Middle Aged, Neoplasm Staging, Polyvinyl Alcohol/therapeutic use, Preoperative Care/methods, Radiology, Interventional, Retrospective Studies, Risk Assessment, Spinal Neoplasms/mortality, Spinal Neoplasms/pathology, Surgical Procedures, Operative/methods, Survival Analysis, Thoracic Vertebrae/blood supply, Thoracic Vertebrae/pathology, Tomography, X-Ray Computed, Treatment Outcome
Pubmed
Web of science
Création de la notice
18/02/2008 11:21
Dernière modification de la notice
03/03/2018 16:25
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