Spinal Metastases from Renal Cell Carcinoma: Effect of Preoperative Particle Embolization on Intraoperative Blood Loss
Christoph Manke
,a,
Till Bretschneidera,
Markus Lenharta,
Michael Strotzera,
Carsten Neumanna,
Josef Gmeinwiesera and
Stefan Feuerbacha
a From the Departments of Diagnostic Radiology (C.M., T.B., M.L., M.S., J.G., S.F.) and Surgery (C.N.), University of Regensburg, Germany.
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FIG 1. A, CT scan in a patient with metastasis involving the T7 vertebral body (asterisk).
B, Selective angiogram of the right 7th intercostal artery with a 5F Cobra-shaped catheter shows a hypervascular mass (arrows) and no arterial supply to the spinal cord.
C, Injection after further selective catheterization with a 3F Tracker catheter (solid arrow indicates catheter tip), protective embolization of intercostal artery distal to the tumor feeders with a platinum coil (open arrow), and embolization with PVA particles. No tumor blush is identified. A coil (arrowhead) is seen in the 6th right intercostal artery after previous embolization
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FIG 2. A, T1-weighted axial MR image shows a large metastasis (asterisk) involving the C2 vertebral body and extending into the surrounding soft tissues.
B, Early arterial phase of a preembolization right vertebral angiogram shows a hypervascular mass (arrowheads) supplied by small cervical branches of the vertebral artery.
C, Right vertebral angiogram obtained after balloon occlusion of the vertebral artery at the level of C1 (arrow) and embolization with PVA particles. No residual tumor stain is visible
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