Trisacryl Gelatin Microspheres Versus Polyvinyl Alcohol Particles in the Preoperative Embolization of Bone Neoplasms

Basile, Antonio; Rand, Thomas; Lomoschitz, F.; Toma, Cyril D.; Lupattelli, Tommaso; Kettenbach, Joachim; Lämmer, Johannes

doi:10.1007/s00270-003-0147-1

Cited by 37 publications

(30 citation statements)

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“…Of 11 patients failing to have LC, 8 were within 120 months, indicating that 10-year survival might be a prognostic threshold to forecast the overall LC rate. Of all included patients, 6 were classified as Campanacci Grade II and 3 as Grade III, but no prognostic significance was observed between the two subgroups in our study.Although no significant difference was shown among embolization materials in our research, as previous demonstrated, Gelfoam, polyvinyl alcohol (PVA), and stainless steel coils for most SAE ran the risk of a short occlusive time of tumor-feeding arteries as well as non-target embolization, which could result in the subsequent failure of LC or even the OS 38,40 . Therefore, superabsorbent polymer microsphere (SAP-MS) is recommended for SAE due to its precise and everlasting occlusion with minimum harm to normal tissue.…”

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confidence: 47%

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Sun

et al. 2017

Orthopaedic Surgery

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Giant cell tumor of the bone (GCTB) is a locally aggressive tumor with a certain distant metastatic rate. For sacral GCT (SGCT) and pelvic GCT (PGCT), surgery has its limitations, especially for unresectable or recurrent tumors. Selective arterial embolization (SAE) is reported to be an option for treatment in several cases, but there are few systematic reviews on the effects of SAE on SGCT and/or PGCT. Medline and Embase databases were searched for eligible English articles. Inclusion and exclusion criteria were conducted before searching. All the clinical factors were measured by SPSS software, with P-values ≤0.05 considered statistically significant. A total of 9 articles were retrieved, including 44 patients receiving SAE ranging from 1 to 10 times. During the mean follow-up period of 85.8 months, the radiographic response rate was 81.8%, with a local control and overall survival rate of 75% and 81.8%, respectively. No bowel, bladder, or sexual dysfunction was observed. Three patients developed distant metastases and finally died. Patients with primary tumors tended to have better prognosis than those with recurrence (P = 0.039). The favorable outcomes of SAE suggest that it may be an alternative treatment for SGCT and PGCT patients for whom surgery is not appropriate.Key words: Local control; Overall survival; Pelvis; Sacral giant cell tumor; Selective arterial embolization Introduction G iant cell tumor of bone (GCTB) is defined as a potential locally aggressive tumor with a distant metastatic rate of approximately 6.6% [1][2][3][4][5][6] . It occurs most in the second to fourth decades of young adults, but also can be found in patients at any other period. Morbidities between men and women are almost equal. Epiphysis and metaphysis of long bones are the most prevalent sites among the GCT occurrence sites, especially at the distal femur and proximal tibia. Sacral giant cell tumor (SGCT) is the third most common GCTB. SGCT accounts for 2%-8% of all GCTB cases, while pelvic giant cell tumors (PGCT) are less frequent [7][8][9][10][11] . Pain is the most common complaint due to the osteolytic destruction. Other clinical manifestations include pathological fracture, losing control of bladder and bowel, as well as sexual dysfunction. Pathological fracture is generally considered as a potential predictor of higher local recurrence and distant metastases rate. GCTB are usually a solid brown mass. Histologically, they contain substantial multinucleated osteoclastlike giant cells and mononuclear stromal cells. According to their radiological appearance, GCTB are classified by Campanacci et al. 5 into three grades: Stage I, latent; Stage II, active; and Stage III, aggressive.Although surgery remains the treatment of choice for local SGCT, it is limited by a high recurrence rate and heavy surgical bleeding due to the complex anatomic structures, regardless of wide excision or intralesional curretage 8,12 . In addition, neurological dysfunction at the expense of incontinence and sexual dysfunction could lead to psychol...

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confidence: 47%

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Sun

et al. 2017

Orthopaedic Surgery

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“…[4,7,14] Many studies compared the performances of spherical and nonspherical particles in embolization procedures, proving the much better efficacy of embolization procedures carried out with spherical particles. [13,15,16] In order to overcome some of the undesirable characteristics of available embolization products, a suspension polymerization process was developed to allow for production of spherical core/shell PVAc/PVA particles for vascular embolization. [1,17,18] The core/shell structure of the final polymer beads leads to lower rates of water absorption (when compared to particles constituted entirely by PVA), resulting in improved volume stability of the particles.…”

Section: Introductionmentioning

confidence: 99%

Expanded Core/Shell Poly(vinyl acetate)/Poly(vinyl alcohol) Particles for Embolization

Peixoto

Melo

Nele

et al. 2009

Macro Materials & Eng

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An improvement to a previously published suspension polymerization process for the production of spherical core/shell PVAc/PVA particles is described. To increase the settling time of the beads in the suspension, an expansion stage was introduced. The core/shell structure was obtained through the partial hydrolysis of the PVAc. The particle density was manipulated through addition of a solvent during the suspension polymerization stage and posterior expansion of the polymer beads obtained at the end of the process. This technique allows for effective reduction of the density of the final polymer beads. The expansion stage exerts also a beneficial effect on particle drying, avoiding particle aggregation during post‐polymerization processing of the polymer beads.magnified image

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“…Radiotherapy is implemented rarely and only to control pain intensity in patients with bone metastases. Embolization of bone metastases performed for similar reasons as in radiotherapy have been reported [1,2]. Systemic treatment is implemented in patients with generalized disease.…”

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confidence: 96%

The Role Of Transarterial Embolization In The Treatment Of Renal Tumors

et al. 2015

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Background. Renal arterial embolization (RAE) is one of the adjunctive methods in the treatment of renal tumors. Embolization is performed in patients prior to nephrectomy, in patients with inoperable renal tumors as palliative treatment.Objectives. The purpose of the study was to present and to analyze our own experiences in the embolization of renal tumors. Material and Methods. A retrospective analysis of 33 patients treated using RAE between 2011 and 2013 was carried out. In 30 cases (91%), embolization was performed due to renal carcinoma and in 3 cases (9%) due to angiomyolipoma. In 11 patients intervention was performed as a palliative procedure because of advanced disease. Histoacrylic glue, polyvinyl alcohol, sponge pledgets and embolization coils were used for embolization. Results. In 20 patients (61%), selective RAE was performed, whereas superselective RAE was carried out in 13 patients (39%). The technical success rate of RAE was 100%. In one case the procedure was complicated by reflux of the histoacrylic glue into the common femoral artery with its embolization that required surgical embolectomy. We used histoacrylic glue in 26 embolizations (79%), in 19 procedures (58%) as the only embolization agent. Polyvinyl alcohol was used in 10 procedures (30%), gelatin sponge pledgets and absolute ethanol in 6 patients (18%). In 4 cases (12%), coils were implemented. In 22 patients (67%), one or more components of postembolization syndrome (PES) developed. In all 22 patients with PES (100%), severe lumbar pain was observed and administration of analgesics proved necessary. In 10 patients treated by palliative embolization, both a regression of macrohaematuria and an increase in hemoglobin level were observed. In 10 further patients, the creatinine level decreased following RAE. Conclusions. RAE is an effective and minimally-invasive intervention burdened with low risk of major complications. PES occurs in about two-third of patients. In the majority of patients after palliative embolization, haematuria decreases and the quality of life improves (Adv Clin Exp Med 2015, 24, 5, 837-843).

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Trisacryl Gelatin Microspheres Versus Polyvinyl Alcohol Particles in the Preoperative Embolization of Bone Neoplasms

Cited by 37 publications

References 20 publications

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Selective Arterial Embolization for the Treatment of Sacral and Pelvic Giant Cell Tumor: A Systematic Review

Expanded Core/Shell Poly(vinyl acetate)/Poly(vinyl alcohol) Particles for Embolization

The Role Of Transarterial Embolization In The Treatment Of Renal Tumors

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