Effect of embolization in the definitive and palliative management of bone and soft tissue tumors of the extremities

Abstract

Introduction: Surgery may be complex in some bone and soft tissue tumors. Preoperative intra-arterial embolization is a developing method for benign and malignant tumors. The present study was done to assess the outcome on the size of tumor and blood loss by preoperative tumor embolization and pain relief in patients with inoperable tumors. Materials and Methods: Twenty-five patients with biopsy-proven bony tumors of extremities were subjected to embolization. In 12 cases, embolization was done preoperatively to decrease the blood loss. In 13 patients, it was done as a palliative treatment to reduce pain, as patients were inoperable. The embolization was done with the right Judkins catheter. Some cases were done with a microcatheter. The material used for embolization was either polyvinyl alcohol (PVA) particles, microcoils, or gel foam used in various combinations, selectively into the feeding vessel. Results: Mean age of the patients was 44.5 years. Fifteen were male and 10 were female. A total of 60 vessels were embolized, 25 with gel foam, 24 with PVA particles, and 11 with microcoils. In 90% of operated patients, gel foam was used, whereas, in almost 100% of nonoperated patients, PVA particles were used. There was a significant decrease in blood loss in patients with preoperative embolization (865 ± 420 vs. 1633 ± 660 ml). In patients with palliative embolization, the mean pain score before embolization was 6.32–2.58, which was decreased to 3. 2–1.53. Conclusion: Preoperative and palliative transarterial embolization of soft tissue and bony tumors is a safe, effective, and minimally invasive modality for pain relief and de-vascularization of large bony tumors in anatomically difficult locations.

Keywords

• angioembolization
• transarterial
• tumor