Abstract No. 399 Perioperative blood loss after embolization of hypervascular musculoskeletal tumors: a single-center 10-year experience

Abstract

To assess outcomes following transarterial embolization of hypervascular bony tumors in patients undergoing orthopedic resection at our institution over a 10-year period. From April 2008 to August 2018, 73 patients with (59 males; mean age 58.1 years) with musculoskeletal (MSK) neoplasms presented for embolization for preoperative devascularization prior to orthopedic surgery and were retrospectively reviewed. Data collected includes demographic data, medical history, pertinent labs (i.e., hemoglobin levels), procedural information, surgical details (estimated blood loss (EBL), intraoperative transfusion), hospital course, and pathology. Fifty-eight patients (47 men, 11 women, range 21-84 years) were included in our analysis. Fifteen patients were excluded from this study (3 patients underwent angiography but were not embolized due to lack of large feeding branch vessel; 12 patients did not proceed to surgery after embolization). The median EBL was 500 mL (range, 100-3000). There was no difference in EBL between RCC (719.6 ± 626.1) and non-RCC groups (855.6 ± 657.5; P = 0.44). The median intraoperative transfusion requirement was 1.0 unit (range, 0-8 ± 2.06). 15.8% of patients required postoperative transfusion (median, 1.5 units; range 1-3). Of patients that received peri-operative transfusion, there was no difference in transfusion requirement in RCC and non-RCC groups (P = 0.88). Of the patients that did not get transfusions, the mean decrease in pre and postoperative hemoglobin was 1.41 g/dL (± 0.51g/dL). There were no complications related to non-target embolization. Preoperative transarterial embolization of hypervascular MSK neoplasms appears to be safe and effective in minimizing peri- and postoperative bleeding while keeping transfusion requirements low.