Giancarlo Facchini1, Piergiorgio Di Tullio2, Milva Battaglia1, Tommaso Bartalena3, Cecilia Tetta1, Costantino Errani4, Andreas F Mavrogenis5, Giuseppe Rossi6. 1. Department of Diagnostic and Interventional Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy. 2. Department of Oncology, Saint Orsola-Malpighi Hospital, Bologna, Italy. 3. Poliambulatorio Zappi-Bartalena, Imola, Italy. 4. Department of Orthopaedics, Istituto Ortopedico Rizzoli, Bologna, Italy. 5. First Department of Orthopaedics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece. afm@otenet.gr. 6. Department of Interventional Angiographic Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy.
Abstract
BACKGROUND: To present palliative selective and superselective arterial embolization with N-butyl-cyanoacrylate for cancer patients with spinal metastases. MATERIALS AND METHODS: We studied the files of 164 cancer patients (94 men and 70 women; mean age 57.6 years; range 35-81 years) treated from March 2003 to March 2013 with 178 selective arterial embolization procedures for metastases of the spine from variable primary cancers. We evaluated the technical success of the embolization procedure with post-procedural angiography, the clinical effect in pain relief, need for analgesics and tumor size reduction, and the embolization-related complications. RESULTS: Post-embolization angiography showed complete occlusion of the pathological feeding vessels in all procedures. Pain score and need for analgesics reduced by 50 % in 159 patients (97 %); no response was achieved in five patients with metastases of the sacrum. The mean duration of pain relief was 9.2 months (range 1-12 months). Metastatic tumor size reduced from a mean of 5.5 cm (range 3.5-7.5 cm) pre-embolization to a mean of 4.5 cm (range 3-5 cm) at the 6-month follow-up; the difference was not statistically significant. Ninety-three patients (56.7 %) experienced embolization-related complications the most common being post-embolization syndrome (80 patients, 48.8 %) followed by leg paresthesias (ten patients, 6 %), and rupture of a lumbar artery (one patient, 0.6 %). CONCLUSION: Selective arterial embolization with N-butyl-cyanoacrylate should be considered for pain palliation of patients with metastases of the spine. However, pain relief is temporary, and complications, although minor may occur.
BACKGROUND: To present palliative selective and superselective arterial embolization with N-butyl-cyanoacrylate for cancerpatients with spinal metastases. MATERIALS AND METHODS: We studied the files of 164 cancerpatients (94 men and 70 women; mean age 57.6 years; range 35-81 years) treated from March 2003 to March 2013 with 178 selective arterial embolization procedures for metastases of the spine from variable primary cancers. We evaluated the technical success of the embolization procedure with post-procedural angiography, the clinical effect in pain relief, need for analgesics and tumor size reduction, and the embolization-related complications. RESULTS: Post-embolization angiography showed complete occlusion of the pathological feeding vessels in all procedures. Pain score and need for analgesics reduced by 50 % in 159 patients (97 %); no response was achieved in five patients with metastases of the sacrum. The mean duration of pain relief was 9.2 months (range 1-12 months). Metastatic tumor size reduced from a mean of 5.5 cm (range 3.5-7.5 cm) pre-embolization to a mean of 4.5 cm (range 3-5 cm) at the 6-month follow-up; the difference was not statistically significant. Ninety-three patients (56.7 %) experienced embolization-related complications the most common being post-embolization syndrome (80 patients, 48.8 %) followed by leg paresthesias (ten patients, 6 %), and rupture of a lumbar artery (one patient, 0.6 %). CONCLUSION: Selective arterial embolization with N-butyl-cyanoacrylate should be considered for pain palliation of patients with metastases of the spine. However, pain relief is temporary, and complications, although minor may occur.
Authors: F Bach; B H Larsen; K Rohde; S E Børgesen; F Gjerris; T Bøge-Rasmussen; N Agerlin; B Rasmusson; P Stjernholm; P S Sørensen Journal: Acta Neurochir (Wien) Date: 1990 Impact factor: 2.216
Authors: G Rossi; A F Mavrogenis; E Rimondi; F Ciccarese; C Tranfaglia; B Angelelli; G Fiorentini; T Bartalena; C Errani; P Ruggieri; M Mercuri Journal: Radiol Med Date: 2011-03-19 Impact factor: 3.469
Authors: Hanna Nowak; Dominika Maria Szwacka; Monika Pater; Wojciech Krzysztof Mrugalski; Michał Grzegorz Milczarek; Magdalena Staniszewska; Roman Jankowski; Anna-Maria Barciszewska Journal: Cancers (Basel) Date: 2022-07-18 Impact factor: 6.575