L'embolizzazione arteriosa selettiva dei tumori ossei

esperienza in 454 casi

Translated title of the contribution: Selective arterial embolisation for bone tumours: Experience of 454 cases

G. Rossi, A. F. Mavrogenis, E. Rimondi, F. Ciccarese, C. Tranfaglia, B. Angelelli, G. Fiorentini, T. Bartalena, C. Errani, P. Ruggieri, M. Mercuri

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: The authors present the experience of a single institution with selective arterial embolisation for primary and metastatic bone tumours. Materials and methods: A total of 365 patients were treated with 454 embolisation procedures from December 2002 to April 2010. Embolisation was the primary treatment for benign bone tumours, adjuvant treatment to surgery for benign and malignant bone tumours and palliative treatment for bone sarcomas and metastases. Indications for repeat embolisation included pain or imaging evidence of progressive disease: 105 patients had repeat embolisation at the same location at an interval of 1-3 months; 260 patients had one embolisation, 78 had two and 29 had three or more. In all patients, N-2-butyl cyanoacrylate (NBCA) in 33% lipiodol was the embolic agent used. Results: A total of 419 of the 454 embolisations (93%) were technically successful. In 35 cases, embolisation was not feasible because of poor lesion vascularisation (21 patients with bone metastases and two with aneurysmal bone cysts), origin of the Adamkiewicz artery in the embolisation field (four patients with bone metastases and one with aneurysmal bone cyst), atheromatosis and arteriosclerosis (five patients with bone metastases) and anatomical and technical problems such as small-calibre vessels, many branches and acute vessel angles (two patients with bone metastases). A clinical response was achieved in 406 of the 419 procedures (97%), and no response in 13 procedures in patients with pelvis and sacrum tumours. Complications included postembolisation syndrome in 81 patients (22%), transient paraesthesias in 41 (11%), skin breakdown and subcutaneous necrosis at the shoulder and pelvis in five (1.4%) and paresis of the sciatic nerve in one (0.3%). Conclusions: We recommend embolisation as primary or palliative treatment or an adjunct to surgery for tumours of variable histology. Strict adherence to the principles of transcatheter embolisation is important. Arteries feeding the tumour and collaterals must be evaluated carefully and catheterised superselectively to protect the normal tissues. NBCA is considered the most appropriate embolic agent for small-vessel occlusion without major complications.

Original languageItalian
Pages (from-to)793-808
Number of pages16
JournalRadiologia Medica
Volume116
Issue number5
DOIs
Publication statusPublished - Aug 2011

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Bone and Bones
Neoplasms
Neoplasm Metastasis
Enbucrilate
Aneurysmal Bone Cysts
Pelvis
Palliative Care
Arteries
Ethiodized Oil
Sacrum
Arteriosclerosis
Paresthesia
Paresis
Sciatic Nerve
Sarcoma
Histology
Necrosis
Pain
Skin
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Rossi, G., Mavrogenis, A. F., Rimondi, E., Ciccarese, F., Tranfaglia, C., Angelelli, B., ... Mercuri, M. (2011). L'embolizzazione arteriosa selettiva dei tumori ossei: esperienza in 454 casi. Radiologia Medica, 116(5), 793-808. https://doi.org/10.1007/s11547-011-0670-0

L'embolizzazione arteriosa selettiva dei tumori ossei : esperienza in 454 casi. / Rossi, G.; Mavrogenis, A. F.; Rimondi, E.; Ciccarese, F.; Tranfaglia, C.; Angelelli, B.; Fiorentini, G.; Bartalena, T.; Errani, C.; Ruggieri, P.; Mercuri, M.

In: Radiologia Medica, Vol. 116, No. 5, 08.2011, p. 793-808.

Research output: Contribution to journalArticle

Rossi, G, Mavrogenis, AF, Rimondi, E, Ciccarese, F, Tranfaglia, C, Angelelli, B, Fiorentini, G, Bartalena, T, Errani, C, Ruggieri, P & Mercuri, M 2011, 'L'embolizzazione arteriosa selettiva dei tumori ossei: esperienza in 454 casi', Radiologia Medica, vol. 116, no. 5, pp. 793-808. https://doi.org/10.1007/s11547-011-0670-0
Rossi G, Mavrogenis AF, Rimondi E, Ciccarese F, Tranfaglia C, Angelelli B et al. L'embolizzazione arteriosa selettiva dei tumori ossei: esperienza in 454 casi. Radiologia Medica. 2011 Aug;116(5):793-808. https://doi.org/10.1007/s11547-011-0670-0
Rossi, G. ; Mavrogenis, A. F. ; Rimondi, E. ; Ciccarese, F. ; Tranfaglia, C. ; Angelelli, B. ; Fiorentini, G. ; Bartalena, T. ; Errani, C. ; Ruggieri, P. ; Mercuri, M. / L'embolizzazione arteriosa selettiva dei tumori ossei : esperienza in 454 casi. In: Radiologia Medica. 2011 ; Vol. 116, No. 5. pp. 793-808.
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