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Long-term outcome of percutaneous alcohol embolization combined with percutaneous vertebroplasty in aggressive vertebral hemangiomas with epidural extension

  • Interventional
  • Published:
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Abstract

Objectives

To evaluate, on a long-term basis, the safety and effectiveness of percutaneous alcohol embolization (PAE) combined with percutaneous vertebroplasty (PVP) as a sole treatment for aggressive vertebral haemangiomas (AVHs) with epidural extension.

Methods

From 1996 to 2015, 26 consecutive patients (15 women [58%] and 11 men; mean age 51.8 years [range: 19–75 years]) underwent PAE combined with PVP (performed at day 15) for the treatment of 27 AVHs with epidural extension. Clinical outcome was evaluated with a mean delay of 88.3 ± 53.3 months (range: 22–217 months). The primary endpoint was pain relief evaluated with a visual analogue scale (VAS).

Results

Pre-procedure mean VAS score was 7.23 ± 1.3 and significantly improved at last follow-up (m = 3.11 ± 1.9; p < 0.001). Ten patients (38.5%) remained asymptomatic. Eighty-eight percent of the patients with neurosensory disorders had complete regression of these symptoms. Two of the three patients with motor deficit did not show any improvement. No major complication was recorded.

Conclusions

PAE combined with PVP is a minimally invasive safe and effective therapeutic approach for AVH with epidural involvement, even on long-term clinical outcome. This technique appears mainly effective for pain and neurosensory symptoms, but seems less effective for motor deficit relief.

Key points

• Combination of PAE with PVP is a safe technique.

• PAE combined with PVP is an effective treatment for sensory symptoms.

• This strategy seems less effective in patients with motor deficits.

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Abbreviations

AVH:

Aggressive vertebral haemangioma

CT:

Computed tomography

DSA:

Digital subtraction angiography

MRC:

Medical Research Council

MRI:

Magnetic resonance imaging

PAE:

Percutaneous alcohol embolization

PMMA:

Poly-methyl-methacrylate

PVP:

Percutaneous vertebroplasty

VAS:

Visual analogue scale

VH:

Vertebral haemangioma

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Acknowledgements

The scientific guarantor of this publication is Jacques Chiras. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Neither approval from the institutional review board nor patient informed consent are required by the ethics committee of our institution for retrospective analyses of patients’ records and imaging data. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l’Hôpital, 75013, Paris, France

    Kévin Premat, Frédéric Clarençon, Évelyne Cormier & Jacques Chiras

  2. Paris VI University Pierre et Marie Curie, Paris, France

    Frédéric Clarençon, Vincent Degos & Jacques Chiras

  3. Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Paris, France

    Jugurtha Mahtout & Vincent Degos

  4. Department of Orthopaedic Surgery, Pitié-Salpêtrière Hospital, Paris, France

    Raphaël Bonaccorsi

Authors
  1. Kévin Premat
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  2. Frédéric Clarençon
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  3. Évelyne Cormier
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  4. Jugurtha Mahtout
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  5. Raphaël Bonaccorsi
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  6. Vincent Degos
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  7. Jacques Chiras
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Corresponding author

Correspondence to Frédéric Clarençon.

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Premat, K., Clarençon, F., Cormier, É. et al. Long-term outcome of percutaneous alcohol embolization combined with percutaneous vertebroplasty in aggressive vertebral hemangiomas with epidural extension. Eur Radiol 27, 2860–2867 (2017). https://doi.org/10.1007/s00330-016-4664-0

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  • DOI: https://doi.org/10.1007/s00330-016-4664-0

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