Paper
Percutaneous alcohol embolization and vertebroplasty of a T2 aggressive vertebral hemangioma with prior embolization of dangerous arterial anastomoses
Published Jul 14, 2022 · Baptiste Bonnet, E. Shotar, K. Premat
Journal of NeuroInterventional Surgery
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Abstract
Aggressive vertebral hemangiomas usually exhibit extraosseous expansion that can result in spinal cord or radicular compression.1 In symptomatic cases, treatment by alcohol embolization and percutaneous vertebroplasty has been reported as feasible, safe, and effective with long-term benefits on neurological symptoms.2 Safety rules before vertebral alcohol embolization include preoperative spinal cord vascularization mapping and opacification through bone needles to assess the absence of dangerous intratumoral anastomoses. In video 1 we present a case of a symptomatic T2 aggressive vertebral hemangioma with dangerous anastomoses between the lesion and both supreme intercostal arteries (SIAs). Embolization by the arterial route of both SIAs was performed, which required good anatomic knowledge of the spinal cord vascularization at the cervicothoracic junction3 4 as a cervical radiculomedullary artery arose from the left costocervical trunk which also fed the left SIA. After occlusion of all dangerous arterial anastomoses, we were able to successfully perform T2 alcohol embolization and percutaneous vertebroplasty. Video 1 Case presentation 10.1136/jnis-2022-019036.video01 6308695923112 BMJ Journals Video Player neurintsurg2022019036media1
Case ReportAlcohol embolization and percutaneous vertebroplasty successfully treated a T2 aggressive vertebral hemangioma with dangerous arterial anastomoses, improving neurological symptoms.
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