Efficacy and Safety of Preoperative Embolisation of Bone Tumours: A Tertiary Centre Experience

Introduction: Preoperative embolisation of bone tumours minimises risk of major intraoperative haemorrhage.Technical success is defined as obliteration of tumour vascularity by ≥70% on post-embolisation angiography.We retrospectively reviewed the technical success, efficacy, and safety of preoperative embolisation of bone tumours in our centre.Methods: Nineteen patients underwent preoperative embolisation of bone tumours from December 2010 to July 2022.Subsequent surgery was performed 1 day post-embolisation.Patient demographics, tumour histology and location, presence of pathological fracture or spinal cord compression, primary embolic agent used, technical success, intraprocedural blood loss, need for blood transfusion, and major complications related to embolisation or subsequent surgery were assessed.Results: Most of the bone tumours were metastases (n = 14) with the majority being hypervascular metastases from renal cell carcinoma or thyroid cancer.The primary bone tumours (n = 5) included vertebral haemangioma (n = 2), plasmacytoma (n = 2), and chordoma (n = 1).Pathological fractures were present in 11 patients.Among the 11 tumours in the spine, eight of them were complicated by spinal cord compression before embolisation.Particles were used as the main embolisation agent in all cases, with 89% technical success.There were no major embolisation-related complications.In patients after successful embolisation, the estimated intraprocedural blood loss ranged from 20 to 3,000 mL.Conclusion: Preoperative embolisation of bone tumours is safe and feasible with high technical success.