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01-11-2021 | Hemangioma | Spinal Neuroradiology

Utility of spinal angiography and arterial embolization in patients undergoing CT guided alcohol injection of aggressive vertebral hemangiomas

Authors: Gopinath Srinivasan, Vinu Moses, Aswin Padmanabhan, Munawwar Ahmed, Shyamkumar N. Keshava, Venkatesh Krishnan, Baylis Vivek Joseph, Krisna Prabhu Raju, Vedantam Rajshekhar

Published in: Neuroradiology | Issue 11/2021

Abstract

Purpose

The purpose of this study is to evaluate the role of spinal angiography and arterial embolization in avoiding spinal cord ischemia in patients undergoing CT-guided alcohol injection of aggressive vertebral hemangiomas.

Methods

In this retrospective study, patients with vertebral hemangioma who underwent CT-guided direct alcohol injection between January 2007 and October 2018 were identified. Of 28 such patients, 26 had neurological deficits, and 2 had only back pain or radiculopathy. Direct alcohol injection without prior arterial embolization was done in 17 patients. Direct alcohol injection with prior arterial embolization was done in 11 patients. Clinical outcome was assessed immediately after the intervention and at follow-up.

Results

Three patients, who underwent alcohol injection without trans-arterial embolization, had worsening of neurological deficits in the post procedure period due to spinal cord ischemia. No complications related to spinal cord ischemia were noted in the embolization group. There was no significant difference in the outcomes between the two groups if the three patients with complications are excluded (p = 0.34).

Conclusion

While CT-guided direct alcohol injection is effective in the management of symptomatic and aggressive vertebral hemangiomas, spinal angiography and trans-arterial embolization of the blood supply to the vertebral body hemangioma, prior to the direct transpedicular alcohol embolization of the lesion, improves the safety of the procedure.

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Title: Utility of spinal angiography and arterial embolization in patients undergoing CT guided alcohol injection of aggressive vertebral hemangiomas
Authors: Gopinath Srinivasan
Vinu Moses
Aswin Padmanabhan
Munawwar Ahmed
Shyamkumar N. Keshava
Venkatesh Krishnan
Baylis Vivek Joseph
Krisna Prabhu Raju
Vedantam Rajshekhar
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Keywords: Hemangioma
Angiography
Hemangioma
Hemangioma
Hemangioma
Hemangioma
Published in: Neuroradiology / Issue 11/2021
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-021-02788-7

At a glance: The STEP trials

Springer Medicine

Utility of spinal angiography and arterial embolization in patients undergoing CT guided alcohol injection of aggressive vertebral hemangiomas

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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