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125475

Role of Trans-Arterial Embolization in Management of Bone Tumors

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Last updated: 22 Jan 2023

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Abstract

Abstract Background: Trans-arterial embolization (TAE) is a prom-ising less aggressive modality in either primary treatment or adjuvant to surgical management of bone tumors. The main aim is to induce necrosis and decrease bleeding and therefore facilitate resection. Palliation of compression manifestation of inoperable bone neoplasm is another indication of TAE. Frequent tumors selected to this modality include vascular tumors (particularly metastases), aneurysmal bone cysts (ABC), giant cell tumor (GCT), and osteosarcoma. Aim of Study: Our aim is to assess the role of embolization in management of bone tumors. Patients and Methods: The current study prospectively evaluated 33 patients (23 males and 10 females). Their age ranged from 9 to 69 years (mean age of 43.246±19.65). Extremities, hip, vertebrae, and skull were involved by variety of bony tumors. Sixteen patients were affected by primary osseous tumors, while 17 patients had metastases. A transar-terial embolization was done in all patients as a preoperative procedure in 15 patients, definite treatmentof primary benign inaccessible tumors in 6 patients, prebiopsy embolization in 6 patients, and as a palliative treatment in 6 patients. Results: Technical success was obtained in 30 out of 33 cases with percentage of 90.9%. All benign and primary malignant bony tumors showed technical success while, 82.4% of metastatic lesions did. Clinical success was achieved in 73.3% cases of first group, 83.3% of second group, 100% of third group and 66.7% of fourth group. Four patients (12.1%) showed no clinical improvement with 9% lost follow-up. Five out of 6 benign tumors showed clinical success (83.3%) as the sixth case lost follow-up (16.7%). Embolization of 9 of primary malignant lesions was clinically successful (90%), whereas 12 out of 17 metastatic lesions were improved clinically (70.6 %), 3 cases showed no clinical success (17.6%), and 2 cases were lost at follow-up (11.8%).
Conclusion: A high consideration should be given totran-sarterialembolization in the algorithmic treatment strategy of bone tumors as it is much safer and effective tool when diminution of bleeding and compression manifestations is to be specifically aimed.

DOI

10.21608/mjcu.2020.125475

Keywords

Transarterial, Embolization, Bone tumors, Microcathetrs, PVA, Gelfoam

Authors

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WALAA MAHMOUD, M.D.;

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MOHAMMED A.A. ELHAWARY, M.D.

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AHMED G. SADEK, M.D.;

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MOHAMED A. BORG, M.D.

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First Name

MOHAMED F.M.

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MOSTAFA, M.D.

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Affiliation

The Departments of Diagnostic and Interventional Radiology* and Orthopedic Surgery**, Faculty of Medicine, Mansoura University, Mansoura, Egypt

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Volume

88

Article Issue

December

Related Issue

14148

Issue Date

2020-12-01

Receive Date

2020-09-25

Publish Date

2020-12-01

Page Start

2,381

Page End

2,389

Print ISSN

0045-3803

Online ISSN

2536-9806

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https://mjcu.journals.ekb.eg/article_125475.html

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https://mjcu.journals.ekb.eg/service?article_code=125475

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47

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Original Article

Type Code

263

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Journal

Publication Title

The Medical Journal of Cairo University

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https://mjcu.journals.ekb.eg/

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Article

Created At

22 Jan 2023