Embolization in the Treatment of Aneurysmal Bone Cysts

Green, J. A.; Bellemore, Michael; Marsden, F. W.

doi:10.1097/01241398-199707000-00005

Cited by 36 publications

(38 citation statements)

References 16 publications

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“…In our study, intraoperative blood loss was 1,614 ml for all patients with spinal OBL and patients with AO suffered much more blood loss than those with CO, which could be attributed to the larger scope and subsequent larger resection range in the treatment of AO. Preoperative embolization has been reported to reduce intraoperative bleeding significantly and can be used as an adjunctive therapy for highly vascular spinal tumors, such as giant cell tumor (GCT) and aneurysmal bone cysts (ABC) [37][38][39]. Although we did not use it in this series, we still consider preoperative embolization a meaningful attempt for spinal OBL, which is a high vascular tumor and often accompanied by a huge amount of intraoperative blood loss.…”

Section: Discussionmentioning

confidence: 94%

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Yin

Wang

et al. 2013

Eur Spine J

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Purpose A retrospective study of 32 patients with osteoblastoma (OBL) in the mobile spine was performed to analyze the clinical characteristics of two types of spinal OBL. We also aimed to find influential factors for OBL in the mobile spine. Methods Between 2002 and 2011, 32 patients with either conventional osteoblastoma (CO) or aggressive osteoblastoma (AO) in the mobile spine were treated in our center. All patients were treated with either total excision or subtotal excision ? postoperative radiotherapy. The mean follow-up was 45.8 (18-128) months. Clinical data and surgery efficacy were analyzed to search for clinical characteristics of two subtypes of spinal OBL and discuss the possible factors influencing relapse. Results There is significant difference between CO and AO in tumor size (p \ 0.0005), preoperative alkaline phosphatase (ALP, p \ 0.0005) and intraoperative blood loss (p = 0.013). Multivariate logistic regression was used to find the influential factors for relapse and the results were: preoperative ALP, b = 0.023, p = 0.029; surgery protocol, b = -7.597, p = 0.007; tumor size, C3/\3, b = 24.805, p \ 0.0005; age, b = 0.054, p = 0.632; and pathology type, b = 1.998, p = 0.34. Conclusions Tumor size, preoperative ALP and CT images were helpful for distinguishing AO from CO. The difference in intraoperative blood loss between CO and AO is mainly attributed to the size of the lesion. Preoperative ALP, surgery protocol and tumor size (C3/\3) were considered to significantly influence relapse of spinal OBL.

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Section: Discussionmentioning

confidence: 94%

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Yin

Wang

et al. 2013

Eur Spine J

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“…13 A taxa de recidiva descrita após a realização deste tipo de procedimento pode atingir números tão elevados como 44%, relacionando-se particularmente com os quistos de dimensão acima de 5 cm. [10][11][12][13][14] No entanto, e perante uma recidiva é sempre possível realizar embolizações seriadas. 5,10 Como todos os procedimentos, a embolização também acarreta riscos, estando a taxa de complicações situada em redor dos 6%.…”

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“…5,10 Como todos os procedimentos, a embolização também acarreta riscos, estando a taxa de complicações situada em redor dos 6%. 5,10,13,14 Constituem complicações desta técnica a disseção da artéria femoral, dor secundária à necrose isquémica do tumor, embolização inadvertida de vasos responsáveis pela vascularização de território não tumoral, infeção, síndrome pós-embolização, entre muitas outras com menor expressão. 5,10,13,14 A embolização de vasos nutritivos de território não tumoral pode constituir uma complicação particularmente grave, com lesões cutâneas, necrose muscular e risco acrescido pela isquémica associada.…”

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“…5,10,13,14 Constituem complicações desta técnica a disseção da artéria femoral, dor secundária à necrose isquémica do tumor, embolização inadvertida de vasos responsáveis pela vascularização de território não tumoral, infeção, síndrome pós-embolização, entre muitas outras com menor expressão. 5,10,13,14 A embolização de vasos nutritivos de território não tumoral pode constituir uma complicação particularmente grave, com lesões cutâneas, necrose muscular e risco acrescido pela isquémica associada. 5 De modo a prevenir estas complicações é fundamental esta técnica ser realizada por um especialista experiente, capaz de avaliar cuidadosamente os vasos nutritivos da lesão e de embolizar seletivamente as artérias patoló-gicas, escolhendo para este fim o agente embólico mais adequado.…”

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Embolização Arterial Seletiva no Tratamento de Volumoso Quisto Ósseo Aneurismático da Bacia

Brito

Portela

2015

Acta Med Port

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RESUMOO quisto ósseo aneurismático corresponde a uma lesão tumoral benigna do aparelho locomotor em idade jovem, que pode adquirir um comportamento biológico agressivo. Estas lesões necessitam frequentemente tratamento cirúrgico através de curetagem e preenchimento com enxerto ósseo, no entanto, em lesões com maior agressividade está indicada a resseção tumoral em bloco. Lesões agressivas apresentam habitualmente grandes dimensões e por vezes são difíceis de abordar cirurgicamente pela localização e necessidade de reconstrução complexa. Neste contexto, a embolização arterial seletiva surge como possibilidade terapêutica adjuvante ou mesmo definitiva. Este trabalho relata um caso paradigmático da utilização da embolização arterial seletiva no tratamento de um volumoso quisto ósseo aneurismático de difícil abordagem cirúrgica. Palavras-chave: Embolização Terapêutica; Ossos Pélvicos; Quistos Ósseos Aneurismáticos. ABSTRACTAneurysmal bone cysts are benign musculoskeletal tumours, which occur in young patients and, occasionally, with aggressive behaviour. Those tumours very often will need surgical treatment with curettage and bone grafting, but for aggressive lesions, in bloc resection is more advisable. Aggressive tumours use to be large and sometimes with difficult surgical approach and demanding complex surgical reconstructions. In this scenario, selective arterial embolization is a possible primary or adjuvant treatment option. This paper presents a paradigmatic case, where selective arterial embolization allowed a successful treatment of a large aneurysmal bone cyst with difficult surgical resolution.

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“…[7][8][9] Only 8 patients who underwent preoperative embolisation for primary benign bone tumours in locations other than the spine have been reported. 7,[10][11][12] We report 6 further patients with benign tumours located around a limb girdle where a tourniquet could not be used.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Embolisation in Benign Bone Tumour Excision

Lee

Nithyananth

Cherian

et al. 2008

J Orthop Surg (Hong Kong)

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Purpose. To assess the role of preoperative embolisation in benign bone tumour excision. Methods. 3 men and 3 women aged 19 to 35 (mean 23) years with either a giant cell tumour or an aneurysmal bone cyst in limb girdle sites underwent preoperative embolisation a day prior to wide local excision by the same surgeon. Tumour size, blood loss, wound healing, infection, and tumour recurrence were assessed. Results. The mean total blood loss was 391 (range, 100-980) ml. No blood transfusion was needed. No patient had any surgery-or embolisation-associated complication. No tumour recurred within a minimum 5-year follow-up. All patients had satisfactory limb function. Conclusion. Preoperative embolisation is useful in the management of vascular and aggressive bone tumours located at limb girdle sites where a tourniquet cannot be used.

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Embolization in the Treatment of Aneurysmal Bone Cysts

Cited by 36 publications

References 16 publications

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Embolização Arterial Seletiva no Tratamento de Volumoso Quisto Ósseo Aneurismático da Bacia

Preoperative Embolisation in Benign Bone Tumour Excision

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