Authors: Raphael Guzman Susan DubachSchwizer Paul Heini KarlOlof Lovblad Daniel Kalbermatten Gerhard Schroth Luca Remonda
Publish Date: 2004/09/16
Volume: 14, Issue: 3, Pages: 263-268
Abstract
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 Twentyfour 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 1900 ml whereas in the two patients who were not embolized it was 5500 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 preinterventional vascularization degree if complete devascularization can be achieved with embolization Preoperative embolization of vertebral hypervascular tumors is safe effective and facilitates tumor resection
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