Preoperative embolisation of a vertebral haemangioma compressing the spinal cord

Benati, A.; Pian, R. Da; Mazza, Carlo; Maschio, A.; Perini, Stefano; Bricolo, Albino; Ore, G. Dalle

doi:10.1007/bf00344326

Cited by 36 publications

(10 citation statements)

References 2 publications

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“…16 Radionecrosis risk has no basis in modern radiation therapy up to a safe dose of 40 Gy for bone irradiation; we delivered a dose of 8 Gy for this benign painful lesion. 17,18 Radiotherapy provides an excellent alternative for patients with refractory heel spur pain.…”

Section: Discussionmentioning

confidence: 99%

Heel spur radiotherapy and radiation carcinogenesis risk estimation

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Heel spur radiotherapy and radiation carcinogenesis risk estimation

et al. 2006

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“…14 Preoperative embolization has also been reported to reduce intraoperative bleeding and improve surgical field visualization. 3,8,9,14,[21][22][23] Some authors have shown that performing surgery in VH patients without first performing embolization can result in very significant blood loss. 10,12 In our patients, preoperative embolization allowed adequate visualization of the surgical field, and none of our patients required blood transfusion during or after surgery; however, we did not have a control group that was operated on without preoperative arterial embolization, against which to compare blood loss.…”

Section: Discussionmentioning

confidence: 99%

Clinical and imaging findings in patients with aggressive spinal hemangioma requiring surgical treatment

Urrutia

Postigo

Larrondo

et al. 2011

Journal of Clinical Neuroscience

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“…When embolisation is performed before surgery, intraoperative bleeding is greatly decreased, reducing the mortality which used to be encountered when operating on these tumours. Embolisation has been carried out by percutaneous methods using methylmethacrylate, 11 intraoperatively with methylmethacrylate 12 and endovascularly using sponge fragments, 13 but to our knowledge, endovascular embolisation with cyanoacrylate components has not previously been described. Selective spinal angiography is essential for demonstrating the arterial supply to the tumour and the artery of Adamkiewicz, which if inadvertently embolised will lead to infarction of the spinal cord.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Endovascular Embolisation of a Vertebral Haemangioma

Clifton

Moore

1997

The Journal of Bone and Joint Surgery. British volume

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We describe the successful relief of compression of the spinal cord due to a vertebral haemangioma by transcatheter embolisation using cyanoacrylate compounds before operation, and provide a brief review of the literature. [Br] 1997;79-B:808-11. Received 24 February 1997; Accepted 10 April 1997 Embolisation for vertebral haemangioma causing paraplegia was first reported in 1972. J Bone Joint Surg1 The traditional treatment in these circumstances had been surgical decompression, with or without postoperative radiotherapy. Embolisation is playing an increasingly important role since it can avoid the need for surgery in some cases. 1,2 A combined approach with preoperative embolisation minimises bleeding during operation and reduces the risk of a postoperative epidural haematoma. CASE REPORTA 33-year-old Caucasian man noted paraesthesiae in both feet after performing leg presses in the gymnasium. His legs became increasingly stiff, the paraesthesiae became worse and he had difficulty in walking. He also had some low back pain which increased on lying down, but he did not experience problems with his bladder or bowel. Examination showed a spastic paraparesis with grade-IV weakness in both legs, worse on the left. He had patchy sensory loss in both legs, with clonus at both ankles and extensor plantar responses.MRI showed haemangiomatous replacement of the T10 vertebra with a soft-tissue component compressing the spinal cord (Fig. 1). A high signal was present in the cord at that level consistent with oedema.The patient underwent spinal angiography and embolisation. A size 5 French Cobra catheter (Cook UK Ltd, Letchworth, UK) was inserted via the right femoral artery and selective catheterisation of the intercostal arteries supplying T9 to T11 was performed. The spinal artery arose from the left T12 intercostal artery. The arterial supply to the haemangioma was from both the left and right T10 intercostal arteries with a large feeder from the right, less supply from the left, and small branches from the right T11 vessel. Embolisation was carried out as a two-stage procedure over two days. First, occlusion of the feeder from the right side of the T10 intercostal artery was carried out with 0.5 ml of cyanoacrylate/lipiodol (50:50) injected through a Tracker 18 (Target Therapeutics, St Albans, UK) catheter placed into the nidus of the haemangioma. On the next day, the left T10 intercostal artery was occluded with 0.4 ml of cyanoacrylate/lipiodol (50:50) since it was impossible to catheterise selectively the small feeders which arose from this artery. A small vessel from the right T11 artery feeder was also occluded with 0.2 ml of cyanoacrylate/lipiodol (50:50). After embolisation no arterial supply to the haemangioma was visible angiographically (Figs 2 to 5).MRI was performed after the embolisation. A high signal return was again seen at T10, consistent with replacement of the vertebral body by haemangiomatous tissue. The softtissue component previously seen within the canal posteriorly showed marked resolution, wi...

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Preoperative embolisation of a vertebral haemangioma compressing the spinal cord

Cited by 36 publications

References 2 publications

Heel spur radiotherapy and radiation carcinogenesis risk estimation

Heel spur radiotherapy and radiation carcinogenesis risk estimation

Clinical and imaging findings in patients with aggressive spinal hemangioma requiring surgical treatment

Preoperative Endovascular Embolisation of a Vertebral Haemangioma

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