Background: The vertebral column is the most common site of bony metastasis. When indicated, surgical resection of hypervascular metastatic lesions may be complicated by significant blood loss, the need for blood transfusion, and incomplete tumor resection due to poor visualization and premature abortion of the operation. In select cases, preoperative arterial embolization of hypervascular metastatic tumors may help minimize intraoperative bleeding and reduce operative times.
Objective: Our aim was to evaluate the effectiveness of preoperative arterial embolization of metastatic tumors to the spine.
Study Design: A systematic review of the literature with a subsequent metaanalysis of the collected data was conducted to achieve this aim.
Methods: PubMed and MEDLINE were searched since inception until May 22, 2023. The primary outcome of this study was Estimated Blood Loss (EBL), while secondary outcomes included number of patients requiring blood transfusions, duration of operation, and survival.
Results: Twenty-nine studies were included, yielding 14,199 patients, from which 1,134 underwent surgery with adjunctive embolization. Our review demonstrated that preoperative arterial embolization in patients with spinal metastatic tumors can help reduce EBL by a mean of -284.37 mL (95% CI 462.43-276. 21, p=.002) and improve survival by 1.20 months (95% CI 1.14-1.26, p<.001) compared to those without embolization. Upon running subgroup analyses, the reduction in EBL appeared to be mainly driven by the embolization of hypervascular tumors, while that of nonhypervascular ones appeared to have no significant impact. The pooled analysis shows that preoperative embolization did not impact operative time and the need for transfusion.
Conclusions: Preoperative arterial embolization of metastatic tumors to the spine has a relatively mild effect in reducing blood loss and improving patient survival. No effect was observed for preoperative embolization on operative time or the need for transfusion.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.spinee.2024.12.032 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Evaluation of Postoperative Prognosis on Carotid Endarterectomy Single Center Experience.
Turk Neurosurg
May 2024
ankara universty.
Aim: Ischemic stroke remains one of the leading causes of death and disability worldwide and ca-rotid stenosis is the leading etiology of ischemic strokes of non-cardiac origin. The chronic inflammatory process and pro-inflammatory state in carotid stenosis seem to be the most im-portant underlying factor in carotid occlusion. In addition to medical therapy and carotid ar-tery stunting (CAS) in the treatment of carotid stenosis, carotid endarterectomy (CEA) is the main surgical treatment of carotid stenosis and its prognosis is the main subject of our study.
View Article and Find Full Text PDFMajor Aortopulmonary Collateral Arteries and Their Effects on Perioperative Parameters and Mortality of Children with Tetralogy of Fallot: A Case-control Study.
Iran J Med Sci
December 2024
Neonatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Inadequate pulmonary blood flow in tetralogy of Fallot (TOF) can lead to the development of major aortopulmonary collateral arteries (MAPCA), which interferes with surgical repair. The present study evaluated the features of MAPCAs among patients with TOF and their treatment approaches. Besides, perioperative parameters and mortality rates of our TOF patients with and without MAPCA were compared.
View Article and Find Full Text PDFPrepancreatic postduodenal portal vein discovered in a pediatric patient undergoing total pancreatectomy with islet autotransplantation: a case report and review of literature.
Front Surg
January 2025
Department of Abdominal Transplant and Hepatopancreatobiliary Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
Background: Prepancreatic postduodenal portal vein (PPPV) is a rare anatomic variant where the portal vein (PV) runs anterior to the pancreas and posterior to the duodenum. Only 20 cases of PPPV, all in adults, have been reported in literature. We report the first case of PPPV in a pediatric patient discovered intraoperatively during total pancreatectomy with islet autotransplantation (TPIAT) and the third known case in which the PPPV could be isolated intraoperatively.
View Article and Find Full Text PDFAberrant anatomical variation of the vertebral artery (VA) from an internal carotid artery (ICA) is considered a rare finding. The incidence of this phenomenon can lead to patients suffering from posterior circulation neurological deficit if the ICA becomes significantly diseased. VA atypical anatomical origin is considered one of the rare pathologies, not only precipitating neurovascular incidents but equally leading to severe difficulty in VA dissection and surgical exposure, especially in carotid artery procedures.
View Article and Find Full Text PDFOutcomes of Coronary Artery Bypass Grafting in Patients With Impaired Left Ventricular Function and the Role of Preoperative Myocardial Viability.
Cureus
December 2024
Cardiovascular Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Background Coronary artery bypass grafting (CABG) improves outcomes in patients with ischemic left ventricular (LV) dysfunction, but accurate patient selection remains critical. Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging aids in assessing myocardial viability, a key predictor of surgical outcomes. This study aimed to evaluate the impact of myocardial viability on postoperative outcomes in patients undergoing CABG.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!