Preoperative Embolization of Metastatic Spinal Cord Compression with n-Butyl Cyanoacrylate: Safety and Effectiveness in Limiting Blood Loss |
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| Institution: | 1. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;2. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York;1. Long Island Jewish Medical Center, Northwell Health System, Queens, New York;2. New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York;3. Zucker School of Medicine at Hofstra University/Northwell Health System, Hempstead, New York;4. Icahn School of Medicine at Mount Sinai Hospital, New York, New York;1. Vanderbilt University School of Medicine, Nashville, Tennessee;2. Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee;3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee;4. Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee;5. Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee;1. Department of Radiology, Kaiser Permanente Oakland Medical Center, Oakland, California;2. Department of Radiology, Kaiser Permanente Richmond Medical Center, Richmond, California;3. Department of Psychology, George Mason University, Fairfax, Virginia;1. Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin;2. Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin;3. Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania;4. Division of Vascular and Interventional Radiology, Department of Radiology, University of California San Diego, La Jolla, California |
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| Abstract: | PurposeTo evaluate the safety and effectiveness of preoperative embolization with n-butyl cyanoacrylate (nBCA) performed for metastatic spinal cord compression (MSCC) in limiting blood loss (BL).Materials and MethodsIn this institutional review board–approved retrospective study, clinical records from 2017 to 2022 were reviewed. Twenty consecutive patients (11 men and 9 women; mean age, 65.8 years ± 10.0; range, 45–82 years) underwent 21 preoperative spine tumor embolizations with nBCA. Angiograms were used to calculate the percentage reduction in tumor vascularity, and relevant clinical data (levels studied and embolized, fluoroscopy time FT], reference dose RD], and Kerma area product KAP]) and operative data (BL and operative time OT]) were analyzed. Adverse events and outcomes were recorded.ResultsA median of 2 levels were embolized per procedure (range, 1–5) but 4.9 were studied (range, 1–10). After embolization, tumor blush was reduced by a median of 87.3% (range, 50%–90%). The mean FT was 41 minutes ± 15.4 (range, 16–67 minutes), the mean RD was 1,977.1 mGy ± 1,794.3 (range, 450.2–6,319 mGy), and the mean KAP was 180.5 Gy·cm2 ± 166.2 (range, 30.4–504 Gy·cm2). The adverse event rate was 1 (4.7%) of the 21 embolizations because a weakness of lower extremities related to swelling was observed. Surgery was performed at a mean of 1.4 days ± 1 (range, 1–5 days) after embolization. The mean surgical estimated BL was 432.5 mL ± 328.5 (range, 25–1,100 mL), and the mean OT was 210.1 minutes ± 97.4 (range, 57–489 minutes).ConclusionsPreoperative embolization of tumors resected for MSCC with nBCA is a safe procedure allowing for performance of surgery with acceptable BL. |
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| Keywords: | FT"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"fluoroscopy time KAP"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"Kerma area product MSCC"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"metastatic spinal cord compression |
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