Embolisation of hypervascular bone tumours: A pictorial essay with literature review

Abstract

SummaryBone tumours, either primary or secondary, can present in various debilitating manners, including pain and pathological fracture. The situation is particularly problematic when the tumours are hypervascular, and located in regions where a high risk of neurological compromise is anticipated during operation, such as in the spine or sacrum. In such situations, bone tumour embolisation is a useful and effective adjunctive treatment for reducing intra-operative blood loss. This is particularly relevant in primary bone tumours such as giant cell tumours and metastatic renal cell and thyroid tumours. With a proper pre-embolisation angiogram and knowledge of anatomy, careful selective cannulation of the arterial supplies and experience in using embolic agents, the risks of non-target embolisation can be kept to minimum and the best result achieved.

Imaging Diagnosis—radiographic, Ultrasonographic, Computed Tomographic, and Fluoroscopic Appearance of a Distal Pelvic Limb Arteriovenous Malformation in a Young German Shepherd Dog

“…8,9 In people, distinguishing between an AVF and AVM has been described as important because therapeutic options for these disease processes can be very different. [1][2][3]11 As the discipline of veterinary interventional radiology advances and percutaneous embolization becomes a viable treatment option for these conditions, differentiation between AVM and AVF will also become of increasing clinical significance. Unfortunately, discerning between a single AVF and a more complex AVM is difficult with clinical evaluation alone, as clinical signs and examination findings are similar for both.…”

“…In people, distinguishing between an AVF and AVM has been described as important because therapeutic options for these disease processes can be very different . As the discipline of veterinary interventional radiology advances and percutaneous embolization becomes a viable treatment option for these conditions, differentiation between AVM and AVF will also become of increasing clinical significance.…”

“…Polyvinyl alcohol particle or cyanoacrylate liquid embolization was considered because of the need to fill an arterial bed consisting of multiple vascular channels. This is in contrast to transarterial coil embolization, which would have been appropriate for a single, relatively large AVF . Imaging proved pivotal in discriminating these vascular aberrations.…”

“…This is in contrast to transarterial coil embolization, which would have been appropriate for a single, relatively large AVF. 1,2 Imaging proved pivotal in discriminating these vascular aberrations. There was risk associated with embolization of vessels feeding the AVM of the present report, as the vasculature to the metatarsal bones and entire pes could be compromised with nontarget embolization, resulting in extensive tissue necrosis.…”

Transcatheter embolization with Squid, combined with other embolic agents or alone, in different abdominal diseases: a single-center experience in 30 patients

“…Type 2 endoleak embolization was performed in patients showing progressive enlargement of the aneurysmatic sac post EVAR with a suspected type 2 endoleak at CT-angiography (Rahimi et al, 2018;Ribé et al, 2017). Pre-surgical arterial embolization was performed in case of voluminous masses or hypervascular tumors (Lau et al, 2013). Varicocele embolization was performed in case of chronic pelvic pain (Laborda et al, 2013).…”