Use Of Embolization Research Articles

Can Segmental Branch Embolization of the Left Gastric Artery Be an Alternative in the Treatment of Recurrent Dieulafoy Lesion Bleeding? A Case report

Dieulafoy lesions, rare developmental vascular malformations within the gastrointestinal system, present a diagnostic challenge due to their inconspicuous nature. These lesions, primarily located near the esophagogastric junction, can lead to life-threatening bleeding. Although accounting for approximately 1.5-2% of upper gastrointestinal bleeding cases, the exact prevalence remains uncertain. Commonly diagnosed through esophagogastroduodenoscopy, the small size of these lesions often results in oversight during initial endoscopy, necessitating a high index of suspicion, especially in cases of recurrent bleeding. While endoscopic methods are the standard treatment, this case presentation introduces the use of embolization as a rare but effective modality in managing recurrent Dieulafoy lesion bleeding. The presented case underscores the importance of diverse treatment approaches and contributes valuable insights to the medical literature, enhancing the understanding and management of this infrequent yet potentially serious condition.

Changes in inpatient brain arteriovenous malformation management in the United States following the ARUBA trial: analysis of an interrupted time series design

The November 2013 online publication of ARUBA, the first multi-institutional randomized controlled trial for unruptured brain arteriovenous malformations (AVMs), has sparked over 100 publications in protracted debates MethodsThis study sought to examine inpatient management patterns of brain AVMs from 2009 to 2016 and observe if changes in U.S. inpatient management were attributable to the ARUBA publication using interrupted time series of brain AVM studies from the National Inpatient Sample data 2009–2016. Outcomes of interest were use of embolization, surgery, combined embolization and microsurgery, radiotherapy, and observation during that admission. An interrupted time series design compared management trends before and after ARUBA. Segmented linear regression analysis tested for immediate and long-term impacts of ARUBA on management. ResultsElective and asymptomatic patient admissions declined 2009–2016. In keeping with the ARUBA findings, observation for unruptured brain AVMs increased and microsurgery decreased. However, embolization, radiosurgery, and combined embolization and microsurgery also increased. For ruptured brain AVMs, treatment modality trends remained positive with even greater rates of observation, embolization, and combined embolization and microsurgery occurring after ARUBA (data on radiosurgery were scarce). None of the estimates for the change in trends were statistically significant. ConclusionsThe publication of ARUBA was associated with a decrease in microsurgery and increase in observation for unruptured brain AVMs in the US. However, inpatient radiotherapy, embolization, and combined embolization and surgery also increased, suggesting trends moved counter to ARUBA’s conclusions. This analysis suggested that ARUBA had a small impact as clinicians rejected ARUBA’s findings in managing unruptured brain AVMs.

Stereotactic radiosurgery with versus without embolization for intracranial dural arteriovenous fistulas: a systematic review and meta-analysis.

Stereotactic radiosurgery (SRS) has been established as a safe and alternative treatment for dural arteriovenous fistulas (dAVFs). While embolization alone is the most commonly used modality for the treatment of dAVFs, the adjunctive use of embolization with SRS, with the growing use of SRS, has gained increasing interest in the past few years. However, the relative efficacy and safety of SRS combined with embolization versus SRS alone for dAVFs remains uncertain. Hence, this systematic review aimed to evaluate the efficacy of SRS with adjunctive embolization for intracranial dAVFs. A systematic review and meta-analysis was conducted by searching electronic databases, including PubMed, Embase, and the Cochrane Library, up to August 2023. All studies evaluating the utilization of adjunctive embolization and SRS for dAVFs were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. A meta-analysis was conducted on the suitable outcomes. Eighteen studies involving 715 patients were included. The mean age of the participants in the study was 64.30 years in the adjunctive embolization group and 60.51 years in the SRS-alone group. In the adjunctive embolization group 41.3% of patients were female, compared with 47.1% in the SRS-only group. The dAVF obliteration rates were 64.7% and 65.7% in the adjunctive embolization and SRS-alone groups, respectively. These obliteration rates were comparable between the two groups (p = 0.96), as were the symptom improvement rates (p = 0.35). Adverse events were rare, and were more commonly associated with the adjunctive embolization procedure, although further causal analysis was not possible. This study provides evidence that adjunctive embolization plus SRS provides similar obliteration and symptom improvement rates compared with SRS alone, with both having very limited SRS-related adverse events. Considering the added burden and adverse events of additional endovascular treatment, the authors recommend embolization be reserved for more complex dAVFs or when embolization can potentially be curative alone or provide more rapid symptomatic relief or protection during the radiosurgical latency period.

Virtual diluted cone beam CT for device apposition assessment during endovascular treatment of intracranial aneurysm: A technical note

The increasing use of embolization devices with suboptimal radio-opacity to treat intracranial aneurysm underscores the need for advanced imaging techniques to characterize device-vessel interactions more accurately. Contrast-diluted cone-beam CT is commonly used in neurointervention but requires additional technical refinements to improve endovascular treatment assessment. In this technical note, we describe the virtual dilution cone beam CT (VDCBCT), a technique that synthetizes non-contrast and contrast-enhanced CBCT images to virtually dilute iodinated contrast agents, thereby facilitating a more accurate assessment of embolization device apposition.Through a set of intracranial aneurysms treated with different embolization devices, we describe the VDCBCT protocol and its usefulness for device apposition confidence.VDCBCT may enhance the global understanding of neurovascular embolization treatments by providing improved visualization of target vessels and low-radio-opacity embolization devices, obviating the need for contrast dilution.

Coils embolization use for coronary procedures: Basics, indications, and techniques.

The use of coils is fundamental in interventional cardiology and can be lifesaving in selected settings. Coils are classified by their materials into bare metal, fiber coated, and hydrogel coated, or by the deliverability method into, pushable or detachable coils. Coils are delivered through microcatheters and the choice of coil size is important to ensure compatibility with the inner diameter of the delivery catheter, firstly to be able to deliver and secondly to prevent the coil from being stuck and damaged. Clinically, coils are used in either acute or in elective setting. The most important acute indication is typically the sealing coronary perforation. In the elective settings, coils can be used for the treatment of certain congenital cardiac abnormalities, aneurysms, fistulas or in the treatment of arterial side branch steal syndrome after CABG. Coils must always be delivered under fluoroscopy guidance. There are some associated complications with coils that can be acute or chronic, that nictitates regular followed-up. There is a need for education, training and regular workshops with hands-on to build the experience to use coils in situations that are infrequently encountered.

483 Partial Treatment as a Risk Factor in Up-Conversion of Type 1 dAVFs

INTRODUCTION: Type 1 dural arteriovenous fistulas (dAVFs) lack cortical venous drainage and occasionally necessitate intervention depending on patient symptoms. Up-conversion is the rare transformation of a dAVF to a higher-grade. Causes for up-conversion are unknown. We tested the hypothesis whether partial treatment of type 1 dAVFs increases their likelihood of up-conversion. METHODS: We used the multicenter Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) database to perform a retrospective analysis of all patients with type 1 dAVFs. Propensity score analysis was utilized to determine if partial treatment was an independent risk factor for up-conversion. A regression model identified secondary risks that contributed to up-conversion. RESULTS: 358 out of 1077 patients within the consortium had type 1 dAVFs. 12% of patients who were partially treated for a type 1 dAVF experienced an up-conversion, while less than 1% of patients who received no treatment experienced up-conversion, and 0% of patients who had a complete treatment of their dAVF experienced up-conversion. Higher proportions of tinnitus, bruits, and intracranial hemorrhage at initial presentation were found in patients who up-converted. The majority of up-converted dAVFs were located in the transverse-sigmoid sinus and all received embolization as part of their treatment. CONCLUSIONS: Partial treatment is an independent risk factor for up-conversion when compared to no treatment or complete treatment. In the partial treatment group, hemorrhage at inital presentation and use of embolization as a treament modality are factors that increase risk for up-conversion.

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Review.

Middle meningeal artery embolization (MMAE) for chronic subdural hematomas (cSDHs) has evolved as a potential treatment alternative for these lesions. The indications for using this treatment modality and the pathophysiology of cSDHs are an area of considerable interest. A retrospective review was performed including all major papers addressing this topic. Although considered a relatively new treatment option, MMAE for cSDHs is gaining widespread popularity. There are many questions that need to be addressed regarding its indications, some of which are the subject of ongoing clinical trials. The efficacy of this treatment modality in carefully selected patients has also provided new insights into the potential pathophysiology of cSDHs. This concise review will focus on the current evidence supporting the use of embolization in the treatment of this disease and highlight unanswered relevant clinical questions regarding MMAE indications and technique.

Embolization of the arteries in the relief of joint and near joint pain: how, when and in whom? A review

This paper presents the results of embolization of popliteal artery branches as an innovative technique to treat pain syndrome not relieved by standard conservative methods for osteoarthritis of the knee joint. The study aimed to evaluate available data on the efficacy and safety of popliteal artery branch embolization in the treatment of pain syndrome in osteoarthritis. Relevant studies on the use of embolization at various degrees of gonarthrosis were analyzed. The results were evaluated using the visual analog scale and Western Ontario and McMaster University Osteoarthritis Index. The performance of patients improved based on both scales, and minor complications resolved on their own. Embolization of the branches of the popliteal artery with insufficiency is a promising and effective treatment method for patients with pain due to osteoarthritis of the knee joint of various degrees, and no serious complications have been identified in the procedures, making it safe.

Interventional angiography utilization for adult trauma patients in Trauma Centers across the United States: An observational study using the National Trauma Data Bank.

Angiography and embolization are part of trauma management protocols for various injuries. This study examines the use of angiography and embolization use in trauma care across Trauma Centers in the United States.We used the National Trauma Data Bank (NTDB) 2017 dataset in this retrospective observational study. Adult trauma patients (≥16 years) who underwent conventional angiography with or without embolization were included. A univariate analysis was carried out to describe patients’ demographic and injury characteristics as well as the time to angiography, angiography details, complications, and outcome (survival to hospital discharge: yes/no). One-year period prevalence proportion of angiography procedure was determined.A total of 4242 patients were included. The 1-year period prevalence proportion of angiography procedure with or without embolization was 0.53% (95% confidence intervals: 0.527–0.529). The median age was 41 years (interquartile range: 27–58) with most patients being in the age group 16 to 64 (83.8%) and males (72.6%). Over half of the patients, 55.4% had an embolization procedure performed in addition to angiography. The mean time to angiography was 263.77 ± 750.19 minutes. The most common embolization sites were the pelvis (24.9%), spleen (11.8%), and liver (9%).This study described angiography and embolization utilization in adult trauma patients in Trauma Centers in the US. Its findings provide the basis for future studies to examine more closely angiography/embolization utilization in specific subpopulations, and to create standardized risk stratification tools for trauma patients who are candidates for this procedure.

Comparing Outcomes in Transcatheter Embolization for the Management of Penetrating versus Blunt Trauma

Abstract Objectives This article assesses potential factors associated with successful embolization and/or mortality benefit among patients with penetrating (PT) compared to those with blunt abdominal trauma (BT) undergoing emergent angiography. Materials and Methods A retrospective study of arterial embolization for BT and PT at a tertiary care academic center in an urban setting between 2018 and 2020 was conducted. Fischer's exact and Student's t-tests were used to assess differences between PT and BT, regarding technical success, in-hospital mortality, number of vessels embolized, and requirement of Operating Room (OR) for bleeding control after embolization. Results Forty-three patients underwent embolization. Twenty-three presented with BT versus 20 with PT. There was no difference in the rate of success between the two groups (91.3% vs. 100%; p = 0.49). No difference was observed in mean days of survival among BT and PT patients treated by embolization (mean [standard deviation]: 13.7 [2.6] vs. 19.1 [2.79] days; p = 0.160). There was no difference in mortality between the two groups (13.0% vs. 10.5%; p = 1.00). Mean number of vessels embolized was higher in the BT group compared to PT (2.26 [1.32] vs. 1.44 [1.03], p = 0.044). The rate of BT patients who required subsequent OR intervention for hemorrhage control after embolization was similar to those with PT (8.7% vs. 10.5%; p = 0.84). Conclusion The rate of mortality, technical success, and requirement of subsequent OR intervention for hemorrhage control was comparable between BT and PT. BT was associated with a higher mean number of vessels embolized compared to PT. Our case series may provide insight in the use of embolization for PT, but further investigation is needed with larger cohorts.

Sinonasal hemangiopericytoma: Report of two cases and review of literature

IntroductionHemangiopericytoma is a low grade malignant vascular tumor. It is rare and is characterised by a poorly clinical presentation and often confused with other fibrous tumor, which could poses difficulties on diagnosis. The nasal cavity is an uncommon site and have a distinct behaviour compared to others location.Case presentationWe report the case of two women who consulted for epistaxis and nasal obstruction. Vascular masses were visualized with nasal endoscopy – one in the left nasal cavity and the second one had a destructive mass of the right hemiface. CT scan and MRI helped identifying the mass, its margins and its extirpability. The Diagnosis was confirmed by histology examination. In one patient, surgery was performed. The second patient had an aggressive and invading tumor for which chemotherapy was performed. The first patient remained free of disease after surgery for a follow-up of 3 years, the second one had a fatal evolution.DiscussionSurgical treatment is the important mainstay, and it still controversial regarding wetherwhether the endonasal surgery could control tumor resection despite the wide performance, nowadays, of endoscopic techniques is still controversial. The use of embolization before surgical removal in place of chemotherapy is still unclear. We report our experience through two cases.ConclusionThe high rate of recurrence of this tumor requires a long follow-up after the most radical surgery possible. The external way must be adopted easily in front of any doubt of complete removal by endoscopy. Endoscopic techniques were regarded as appropriate for small low-vascularized tumors only.

EMBOLIZATION IN RECURRENT SOFT TISSUE AMELOBLASTOMA EXCISION OF THE MANDIBLE

Background: Recurrent ameloblastoma can occur after radical treatment, 13.3% up to 19% involves soft tissue. Case of recurrent mandibular ameloblastoma in soft tissue, bleeding is one of the risks that often occurs. One way to reduce intraoperative bleeding is by embolization. Purpose this studi to report the benefits of embolization to reduce intraoperative bleeding in the action of recurrent ameloblastoma in soft tissue. Method: Female patient 32 years old came to RSUP Dr. Sardjito with complaint of lump on her left cheek, with history of post-hemimandibulectomy ameloblastoma 14 years ago. Objective examination of the asymmetrical patient's face with swelling extends to the cheek and pain when pressed, and the size is around 10x10 cm. Embolization using PVA and gelfoam material done before the excision of the tumor to reduce the risk of bleeding. The excision in this case is using lip split method, with bleeding during surgery around 250 ml. Biopsy results after excision are multicystic ameloblastoma, some are follicular types and some are plexiform types Conclusion: The use of embolization in the case of recurrent mandibular ameloblastoma in soft tissue can reduce tumor size and reduce bleeding during surgery.

Effectiveness of Preoperative Embolization in Patients with Spinal Metastases: A Systematic Review and Meta-Analysis

Debate on the effectiveness of preoperative embolization for spinal metastatic lesions, especially for nonhypervascular tumors, has persisted. The present study aimed to identify the effectiveness of preoperative embolization in patients who had undergone surgery for spinal metastasis. Two of us (Z.T. and Z.H.) independently searched the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases to identify eligible clinical studies that had compared the outcomes of patients treated surgically for spinal metastatic disease with or without preoperative embolization. The primary outcomes included intraoperative blood loss, perioperative blood loss, and transfusion requirements. The secondary outcomes include the operative time, overall survival, and complication rates. Meta-analyses were performed for subgroups of hypervascular, nonhypervascular, and mixed tumors. A fixed effects model was applied when I2 was <50%, and a random effects model was applied when I2 was >50%. A total of 12 studies (1 randomized controlled trial and 11 retrospective case-control studies), with 744 patients, were included. Significantly less intraoperative blood loss (mean difference [MD],-1171.49 mL; 95% confidence interval [CI],-2283.10 to-59.88; P= 0.039), fewer blood transfusions (MD,-3.13 U; 95% CI,-4.86 to-1.39; P<0.001), and shorter operative times (MD,-33.91 minutes; 95% CI,-59.65 to-8.17; P= 0.010) were identified for the embolization group in the hypervascular subgroup. In the nonhypervascular and mixed tumor subgroups, no differences in effectiveness were identified in blood loss, transfusion requirement, or operative time when stratified bythe use of embolization. The overall survival and complication rates were similar between the embolization and nonembolization groups in each subgroup. The current data support the use of preoperative embolization for hypervascular metastatic tumors to the spine. However, little evidence is available to support the use of preoperative embolization for nonhypervascular metastatic tumors to the spine.

Can uterine artery embolization be an alternative to plastic and reconstructive uterus operation by minimally invasive surgery?

Introduction: Plastic and reconstructive minimally invasive surgery has been established as gold standard in myomectomy. Therapy failure eventually leads to future surgical interventions or hysterectomy: surgeons and patients should be aware of the risks and benefits. We conducted a systematic review to analyse the evidence on the therapeutic indications and adverse events associated with uterine artery embolization and thereby evaluating if this method could be a valid alternative therapy. Methods: In concordance with PRISMA guidelines, literature research was made in PubMed, Cochrane Library, UpToDate, Amboss and Medline databases. Clinical trials, reviews and case reports published in English between January 2010 and June 2020 were included. Results: 44 articles were included out of 838 papers identified at initial search. Regarding uterine fibroids, three original papers and one Cochrane review reported the benefits of the procedure as an alternative to surgery, even in large and giant fibroids. Furthermore, several studies discussed the use of embolization for postpartum haemorrhage to decrease rates of hysterectomy after other haemostatic methods were exhausted, because of the potential risk of abnormal placentation in a future pregnancy. The procedure can also be successfully used as prophylactic method in different obstetrical procedures. Conclusions: The use of embolization in different uterine pathologies is a minimally invasive procedure as an alternative to surgery, especially in women who desire to preserve their uterus. Its related complications are described and can be avoided by a stringent indication of the procedure. More evidence regarding fertility after UAE, use of the procedure prophylactically in obstetrical haemorrhage or in adenomyosis is needed.

Indications and Usefulness of Embolization for Unruptured Middle Cerebral Artery Aneurysms

Indications and Usefulness of Embolization for Unruptured Middle Cerebral Artery Aneurysms

Management of Splenic Trauma in Contemporary Clinical Practice: A National Trauma Data Bank Study

To evaluate the utilization and efficacy of various treatments for management of adult patients with splenic trauma, highlighting the evolving role of splenic artery embolization. The National Trauma Data Bank (NTDB) was queried for patients who sustained splenic trauma between 2007 and 2015, excluding those with death on arrival and selected nonsplenic high-grade injuries. Patients were categorized into (1) nonoperative management (NOM), (2) embolization, (3) splenectomy, (4) splenic repair, and (5) combined treatment groups. Evaluated outcomes included hospital length of stay (LOS), intensive care unit LOS, mortality, and NOM and embolization failures. Overall, 117,743 patients with splenic predominant trauma were included in this study. Over the 9-year study period, 85,793 (72.9%) were treated with NOM, 21,999 (18.9%) with splenectomy, 3895 (3.3%) with embolization, and 2131 (1.8%) with splenic repair. From 2007 to 2015, mortality rates declined from 7.6% to 4.7%. The rate of NOM did not significantly change over time, while embolization increased 369% (1.3%-4.8%). Failure of NOM was 4.4% in 2007 and decreased to 3.4% in 2015. Across all injury grades, NOM had the shortest LOS (8.3 days), followed by splenic repair (12.3), embolization (12.6), and splenectomy (13.8) (p < 0.001). When adjusted for various clinical factors including severity of splenic injury, mortality rates were 7.1% for splenectomy, 3.2% for embolization, and 2.5% for NOM. Most patients with splenic-dominant blunt trauma are managed with NOM. Over time, the use of embolization has increased while open surgery has declined, and mortality has improved for all treatment methods. Compared to splenectomy, embolization is associated with shorter hospital LOS but is still used relatively infrequently.

A Review of Interventional Radiology Treatments for Chronic Pain

Interventional radiology procedures are being increasingly used to mitigate chronic pain. In addition to established therapies such as thermal bone lesion ablation, kyphoplasty, and chemical neurolysis, ongoing research has shown promising results for the use of embolization in treatment of osteoarthritic knee pain and chronic pain secondary to adhesive shoulder capsulitis. This review will highlight some of the most common interventional radiology pain procedures, as well as provide insight into future pain-relieving embolization.

Актуальные проблемы и перспективы применения методов ядерной медицины в диагностике и лечении гепатоцеллюлярной карциномы: аналитический обзор

In the presented review of publications, together with a brief analysis of the incidence, risk factors for the occurrence and methods of diagnosis of hepatocellular carcinoma (HCC), current problems and prospects for the application of nuclear medicine methods in the diagnosis and treatment of this disease are indicated. Hepatocellular carcinoma is one of the most common malignant tumors of the liver and is characterized by a rapidly progressing course with an unfavorable life expectancy. A variety of clinical manifestations of the disease creates certain difficulties in the early diagnosis of HCC. Although HCC screening is most commonly used to determine the level of alpha-fetoprotein (AFP), ultrasound (US), bolus CT and MRI, experience in the use of radionuclide imaging diagnostics, including positron emission tomography, is important in clinical practice (PET), which, not being the main method of primary diagnosis of HCC, however, confirmed their relevance in the differential diagnosis between a benign tumor and metastasis with unclear diagnostic data, as well as in the process of monitoring treatment and in the diagnosis of distant metastases. Conceptual issues in determining the treatment strategy of patients with HCC, depending on the staging of the disease, the prospects for optimizing treatment strategies and traditional methods of treating HCC in detail and in depth are covered in various publications, including publications of domestic authors. Based on this, the authors of the article limited themselves to a brief analysis of the use of embolization and radiation therapy methods for treating HCC, the active development of which in the last decade, as well as promising early results of treatment, suggest that radiation therapy can be considered as the main treatment method for HCC traditional methods. &#x0D; Further study and development of radionuclide methods for the diagnosis and therapy of HCC, as well as the search and study of new radiopharmaceuticals for diagnosis and regional intraarterial radiotherapy is one of the promising directions in modern approaches to the diagnosis and treatment of HCC.

1995 Small Bowel Variceal Bleeding Successfully Treated With Percutaneous Coil Embolization

INTRODUCTION: The small intestine is the most common cause of obscure gastrointestinal (GI) bleeding. Approximately 5% of GI bleeding occurs from the small bowel, defined as the region between the ligament of Treitz and the ileocecal valve. Controlling the bleed in this area is challenging because of its intra-peritoneal location and long length. Patient with small bowel bleeding typically undergo multiple diagnostic evaluations because of the inability to visualize the small bowel properly. However, wireless capsule endoscopy, double balloon enteroscopy, and computed tomography enterography (CTE) have improved the ability to investigate these bleeds. We report a case of small bowel varices successfully treat by percutaneous coil embolization via the superior mesenteric vein (SMV). CASE DESCRIPTION/METHODS: A 60-year-old female with non-alcoholic steatohepatitis (NASH) cirrhosis was admitted due to dark stools and acute encephalopathy. Prior to this, the patient was worked-up extensively at another facility for the same complaints with EGD, colonoscopy, CTE, and push enteroscopy which was minimally revealing. Initial laboratory values showed a hemoglobin (Hgb) of 9.8 g/dl with a drop to 7.0 g/dl which required transfusion of three units packed red blood cells. She underwent wireless capsule endoscopy that revealed a large, active bleed in the mid small bowel due to varices. Immediately following, the patient underwent successful direct percutaneous access of the small bowel venous varix, supplied by a prominent SMV branch, by coiling a portion of the varix and the venous inflow. After the procedure, there was clinical resolution of the gastrointestinal bleeding and her hemoglobin returned to baseline. DISCUSSION: Even though small bowel variceal bleeding is rare, it can be life threatening without treatment. Early recognition and prompt management is useful in reducing unnecessary diagnostic tests for the patient. The treatment of small bowel varices includes surgery, transjugular intrahepatic portosystemic shunt (TIPS), dilatation of a stenosed portal vein, enteroscopic sclerotherapy, and percutaneous embolization. Intervention angiography was selected for this patient rather than TIPS due to the presence of hepatic encephalopathy. Though further studies are needed to confirm the use of embolization as first line therapy for small bowel variceal bleeding, it should be considered when evaluating small bowel bleeds as it can offer successful outcomes.

Denosumab: A potential new treatment option for recurrent Aneurysmal Bone Cyst of the spine.

ABCs are expansile osteolytic lesions typically containing blood-filled spaces separated by fibrous septae. Standard treatment includes surgical resection or curettage and packing; however, for some spinal lesions, the standard approach is not optimal. One therapeutic strategy is to treat spinal ABC with an agent that targets a pathway that is dysregulated in a disease with similar pathophysiology. Denosumab, a human monoclonal antibody to RANKL is effective in the treatment of GCT's. Spinal ABCs are a therapeutic challenge and local recurrence is a concern. We report a case of aggressive recurrent ABC of dorsal spine in a 14-year old female with progressive neurologic deficit who underwent surgical excision and decompression with a recurrence in a short period for which a decompression and fixation was done. She had a recurrence after an asymptomatic period of 6 months and neurologic worsening. Having ruled out use of embolization and radiotherapy, a remission was achieved by treatment with Denosumab using the regimen for GCTs for a duration of 6 months. Follow-up MRI and CT scans at 24 months following inception of Denosumab depicted complete resolution and no recurrence. We conclude that Denosumab can result in symptomatic and radiological improvement in the recurrent locally aggressive ABC and may be useful in selected cases. Long-term results are mandatory to confirm the efficacy of Denosumab and to evaluate local recurrence after stopping Denosumab.