Pre-operative Embolization for Bone Tumors; Single Center Experience

Abstract

Objective: The purpose of this study was to report our experience with 35 patients, presenting with primary or secondary bone tumors, who underwent pre-operative transarterial embolization in our institution. Methods: Pre-operative transarterial embolizations between 2009 and 2013 were retrospectively reviewed in 35 patients (20 men and 15 women), with a mean age of 49.29 years, range 15-79 years. Medical records were reviewed to obtained patient’s data, histological diagnosis, anatomical site, post embolization complication, interval between embolization and surgery, operative procedure and operation time. Estimated blood losses (EBL) were obtained from operative notes or anesthetic notes. Results: Thirty-five patients had a total of 43 procedures in 5 years period, in which five patients underwent twice and one patient underwent four pre-operative embolizations. All 43 pre-operative embolization procedures were technically successful and underwent surgery after embolization, with a mean of 2.7 days, range 0-15 days. No patient experienced embolization associated major complication. The mean estimated blood loss was 2,915 mL (range 20-14,000 mL). Conclusion: Pre-operative transarterial embolization of both primary and secondary bone tumors was safe and effective and can help to reduce intra-operative blood loss particularly when superselective embolization was performed. Blood loss during surgery increased if the operation was not performed within 3 days after embolization due to re-canalization and angiogenesis.