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European Radiology

, Volume 27, Issue 7, pp 2860–2867 | Cite as

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

  • Kévin Premat
  • Frédéric Clarençon
  • Évelyne Cormier
  • Jugurtha Mahtout
  • Raphaël Bonaccorsi
  • Vincent Degos
  • Jacques Chiras
Interventional

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.

Keywords

Intraosseous haemangioma Cementoplasty Alcohol embolization Percutaneous Vertebral 

Abbreviations and acronyms

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

Notes

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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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Kévin Premat
    • 1
  • Frédéric Clarençon
    • 1
    • 2
  • Évelyne Cormier
    • 1
  • Jugurtha Mahtout
    • 3
  • Raphaël Bonaccorsi
    • 4
  • Vincent Degos
    • 2
    • 3
  • Jacques Chiras
    • 1
    • 2
  1. 1.Department of Interventional NeuroradiologyPitié-Salpêtrière HospitalParisFrance
  2. 2.Paris VI University Pierre et Marie CurieParisFrance
  3. 3.Department of AnaesthesiologyPitié-Salpêtrière HospitalParisFrance
  4. 4.Department of Orthopaedic SurgeryPitié-Salpêtrière HospitalParisFrance

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