Trends in Utilization of Preoperative Embolization for Spinal Metastases: A Study of the National Inpatient Sample 2005–2017

Wahood, Waseem; Alexander, A. Yohan; Yolcu, Yagiz U.; Brinjikji, Waleed; Kallmes, David F.; Lanzino, Giuseppe; Bydon, Mohamad

doi:10.5469/neuroint.2020.00381

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…Next, we discuss the clinical benefits of this procedure as reported in the primary literature, with benefits ranging from pain improvement as a palliative measure to significant decreases in blood loss intraoperatively. Overall, the use of preoperative embolization resulted in more favorable outcomes (6,(35)(36)(37).…”

Section: Clinical Outcomes After Tumor Embolizationmentioning

confidence: 99%

Spinal tumor embolization: benefit for surgical resection

Maddy¹,

Trenchfield²,

Destine³

et al. 2023

BIJNN

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The embolization of hypervascular spinal tumors preoperatively has shown to be a worthwhile adjunctive procedure to minimize the elevated risks associated with surgical resection, such as intraoperative blood loss and its associated complications. Resection of these hypervascular tumors is necessary for local tumor control, reduction in patient-reported pain, improved neurological functioning, and spinal stability. This adjunctive procedure has been associated with improved surgical outcomes and easier facilitation of surgical resection. As such, we provide a review of the current literature examining the employment of this technique. Specifically, this article (a) reviews the techniques of embolization, with anatomical considerations of the arterial framework of the spinal network; (b) relativizes and outlines the post-embolization management of spinal tumor resection; (c) provides a critical outlook on the reported benefit of preoperative embolization before surgical resection with support from clinical studies in the literature; and (d) discusses the efficacy and reliability of provocative testing and post-procedural management and follow-up. Ultimately, a thorough and updated review of preoperative spinal tumor embolization and its clinical benefits will summarize the current fund of knowledge and encourage future research toward continued improvements in patient outcomes for those needing to undergo surgical resection of spinal lesions.

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Section: Clinical Outcomes After Tumor Embolizationmentioning

confidence: 99%

Spinal tumor embolization: benefit for surgical resection

Maddy¹,

Trenchfield²,

Destine³

et al. 2023

BIJNN

View full text Add to dashboard Cite

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“…Preoperative transcatheter arterial embolization (preoperative embolization) has emerged as an effective procedure for reducing intraoperative blood loss. [1][2][3][4][5][6] Furthermore, several metaanalyses have indicated that preoperative embolization of hypervascular metastatic tumors, such as renal cell carcinomas and thyroid cancers, can reduce intraoperative blood loss. [7][8][9] Additionally, there are several reports on the efficacy of cone-beam computed tomography arteriography (CTA) in preoperative embolization, which produced an excellent three-dimensional configuration of tumor-feeding blood vessels and required relatively few digital subtraction angiography (DSA) runs.…”

mentioning

confidence: 99%

Efficacy of Subtraction Computed Tomography Arteriography During Preoperative Embolization in Spinal Tumors

Makishima,

Yamamoto,

Yata

et al. 2024

Yonago Acta Med.

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Background This study aimed to evaluate the efficacy of subtraction computed tomography arteriography (s-CTA) during preoperative embolization in spinal tumors. Methods The study analyzed 17 vertebrae in 13 patients who underwent preoperative embolization before spinal fixation surgery for malignant spinal tumors to decrease blood loss at our hospital from 2019 to 2021. Their ages ranged from 56 to 88 years (average, 73.5 years). Metastatic bone tumors were most common, including five cases originating as lung carcinomas and three as renal cancers. After digital subtraction angiography of selected tumor-feeding arteries and nonsubtraction CTA (ns-CTA) were performed, s-CTA was conducted using data obtained from both procedures. A clarity score of the boundary between the normal bone and tumor was derived for each patient, which was then classified into four grades (good, 3 points; fair, 2 points; faint, 1 point; poor, 0 points) by two experienced radiologists, followed by a comparison between the s-CTA and ns-CTA groups using the Wilcoxon signedrank test. Results Clarity scores were significantly higher in the s-CTA group than in the ns-CTA group (P < 0.001). The agreement of Cohen's coefficients between the two radiologists was κ = 0.724 in s-CTA scoring and κ = 0.622 in ns-CTA scoring, which were moderately matched. Seven arteries were not embolized due to insufficient tumor contrast enhancement and their poor relation to the surgical invasion zone. No complications were observed during or after embolization. Conclusion S-CTA successfully distinguished between tumor and normal bone and may help avoid unnecessary embolization.

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