Semin intervent Radiol 2018; 35(04): 268-280
DOI: 10.1055/s-0038-1673418
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Cement Injection for the Palliative Treatment of Osseous Metastases: A Technical Review

Steven Yevich
1   Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
,
Lambros Tselikas
2   Department of Interventional Radiology, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France
,
Guillaume Gravel
2   Department of Interventional Radiology, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France
,
Thierry de Baère
2   Department of Interventional Radiology, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France
,
Frederic Deschamps
2   Department of Interventional Radiology, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France
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Publikationsdatum:
05. November 2018 (online)

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Abstract

The technical art to percutaneous injection of polymethyl methacrylate (PMMA) cement for the palliative treatment of osseous metastases is not without pitfalls. Pathologic fracture, cortical bone erosion, large lytic tumor, aggressive tumor biology, and tumor vascularity may increase the risk of cement leakage or limit complete consolidation. A calculated and determined approach is often necessary to achieve satisfactory patient-tailored results. This article reviews the challenges and potential complications during the consolidation of osseous metastases. Case examples are presented to facilitate early detection of impending cement leakage, minimize procedural risks, and provide management suggestions for complications. Technical pearls are provided to refine consolidative techniques and improve the comprehensive treatment of painful osseous metastases.