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Semin intervent Radiol 2019; 36(03): 241-248
DOI: 10.1055/s-0039-1693120
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Update on Preoperative Embolization of Bone Metastases

Jingqin Ma
1   Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical School of Fudan University, Shanghai, People's Republic of China
,
Thomas Tullius
2   Department of Radiology, The University of Chicago Medicine, Chicago, Illinois
,
Thuong G. Van Ha
2   Department of Radiology, The University of Chicago Medicine, Chicago, Illinois
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Publikationsdatum:
19. August 2019 (online)

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Abstract

Management of patients with bone metastasis is complex and should include different specialties. Goals of therapy should be identified for each individual patient prior to the start of treatment. Preoperative embolization has generally been considered a safe and effective means of reducing intraoperative blood loss with recent studies and advances in technique reported. Update on indications, contraindications, technique, and efficacy, as well as prognostic factors and complications of preoperative embolization of bone metastases will be reviewed. New trends such as transradial arterial access and usage of liquid embolic agents will be discussed. Large tumor size, increased preprocedural tumor vascularity, longer embolization-to-surgery interval, and radical surgical procedures are associated with greater intraoperative blood loss and prolonged operative time. An accurate, noninvasive method to evaluate tumor vascularity prior to angiography is needed to identify patients who are most likely to benefit from preoperative embolization. Particular attention will be paid to skeletal metastases and spinal metastases as each has its own set of complexity.

Keywords

interventional radiology - bone metastasis - embolization - surgery