Angiographic assessment and control of potential operative hemorrhage with pathologic fractures secondary to metastasis.

Two cases are reported, which demonstrate the contribution of angiography to the operative management of neoplastic, pathologic fractures. The degree of fracture site neovascularity was assessed by pre-operative arteriography. Selective trans-catheter gelatin-foam embolization was then employed to markedly reduce or obliterate the arterial supply to lesions shown to be richly vascular. Open reduction and internal fixation was subsequently accomplished with minimal operative hemorrhage.