Preoperative Embolization in Surgical Treatment of Spinal Metastases: Single-Blind, Randomized Controlled Clinical Trial of Efficacy in Decreasing Intraoperative Blood Loss

Clausen, Caroline; Dahl, Benny; Frevert, Susanne; Hansen, Lars Valentin; Nielsen, Michael Bachmann; Lönn, Lars

doi:10.1016/j.jvir.2014.11.014

Cited by 64 publications

(72 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is also evidence showing that embolization may decrease the time of the operation. A retrospective study of 46 patients with MESCC treated with preoperative embolization showed a significant reduction in intraoperative blood loss, although a randomized, prospective study of 45 patients found the decrease in blood loss to be notable only in a subgroup analysis of hypervascular tumors . In this study, however, there was a significant decrease in the surgical time, with median procedure times of 124 minutes in the control arm and 90 minutes in the embolization arm …”

Section: Surgerycontrasting

confidence: 61%

Diagnosis and treatment of epidural metastases

Yáñez

Miller

Batchelor

2016

Cancer

View full text Add to dashboard Cite

Epidural metastases occur in 5% to 10% of cancer patients and represent a neurological emergency. Patients most commonly present with an acute onset of motor weakness, and restoration of neurological function is critically dependent on prompt diagnosis and treatment. This review discusses the clinical, epidemiological, and radiological features associated with epidural metastases and resulting spinal cord compression. Moreover, current treatment paradigms are reviewed. The timely initiation of radiation as well as surgery in select cases is critical for preserving neurological function and achieving local tumor control and pain control. Future studies investigating surgical and radiation treatment for metastatic epidural cord compression are urgently needed. Cancer 2017;123:1106-1114. © 2016 American Cancer Society.

show abstract

Section: Surgerycontrasting

confidence: 61%

Diagnosis and treatment of epidural metastases

Yáñez

Miller

Batchelor

2016

Cancer

View full text Add to dashboard Cite

show abstract

“…14 In a recent study, Clausen et al concluded that blood loss differences between patients who received embolization and those who did not were significant, but too small to be clinically important. 15 We found no statistically significant association between methods of bleeding control (embolization or the application of local hemostatic agents). Therefore, we believe indications for embolization of MRCC before posterior decompression surgery could be reconsidered in the future, as modern hemostatics provide adequate control of hemorrhage in palliative management.…”

Section: Discussioncontrasting

confidence: 53%

Renal Cell Carcinoma Metastasis of the Spine: Bleeding Control Methods

et al. 2018

View full text Add to dashboard Cite

Objective: This report compares various methods of bleeding control, and their influence on outcome and survival after decompression procedures for spinal metastasis of renal cell carcinoma (MRCC). Methods: A retrospective study. All patients underwent palliative decompression procedures. We compared 3 groups of patients stratified by methods of bleeding control. The first group (EMB) included 22 patients who underwent preoperative embolization of a tumor. The second group (HEM) consisted of 20 patients, treated surgically using intraoperative local hemostatic agents. In the third group (COMBI) 15 patients were treated with a combination of methods. Results: The average intraoperative blood loss for the EMB group was slightly less than the average for the HEM and COMBI groups, but without significant differences. The postoperative drainage loss in the HEM and COMBI groups was significantly less than in EMB group. The complication rate (infections, hematomas, neurological deficit) was practically equal in all groups. No statistically significant differences in local tumor recurrence and overall survival were found between groups. Conclusions: The overall results did not show that usage of different bleeding control methods can affect early or long-term outcomes. Level of Evidence III; retrospective study.

show abstract

“…There was one single-blind prospective RCT6 and five retrospective studies conducted in a single institute 3–5 7 10. The number of enrolled patients ranged from 15 to 46, with an average age ranging from 55 to 64 years.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, Wirbel et al 5 reported that PE before anterior resection of spinal metastases resulted in significantly less blood loss than a non-embolized group. Clausen et al 6 conducted a single-blind randomized controlled trial (RCT) comparing IBL between PE and control groups in 45 patients with spinal metastases who underwent posterior decompressive thoracic/lumbar spinal surgery in which the average IBL did not differ significantly…”

Section: Introductionmentioning

confidence: 99%