Percutaneous low-pressure bone stenting to control cement deposition in extensive lytic lesions.

Abstract

OBJECTIVE:

To evaluate low-pressure bone stenting combined with cementoplasty in extensive lytic lesions.

METHODS:

A single-centre study involving four consecutive patients (four women) with extensive lytic tumours was performed. The average age was 65 years. Surgical treatment was not indicated or not wished for by the patients. Institutional review board approval and informed consent were obtained. Percutaneous consolidation was performed by an interventional radiologist under fluoroscopy guidance. Follow-up was assessed using the visual analogue scale (VAS).

RESULTS:

Under general (n = 2) or local (n = 2) anaesthesia, five 11-gauge bone biopsy needles were advanced in four lesions. Five auto-expandable uncovered stents (10-14 mm diameter and 40-60 mm long) were inserted. In all cases, bone cement was successfully placed into the tumours. The volume of cement that was injected through the cannulas into the stents was 5-10 mL. Using VAS, pain decreased from more than 9/10 preoperatively to less than 2/10 after the procedure for all patients (p < 0.05). No complications occurred during the follow-up (8-19 months).

CONCLUSION:

This study suggests that cementoplasty combined with low-pressure bone stenting could allow effective bone stabilization resulting in pain relief.

KEY POINTS:

• Low-pressure bone stenting is possible. • This technique improves cement injection control. • The procedure allows effective bone stabilization resulting in pain relief.

• Authors: Francois H Cornelis, Francois Petitpierre, Thierry Fabre, Olivier Gille, Nicolas Amoretti, Olivier Hauger
• Journal: European radiology (Eur Radiol) Vol. 27 Issue 9 Pg. 3942-3946 (Sep 2017) ISSN: 1432-1084 [Electronic] Germany
• PMID: 28124748 (Publication Type: Case Reports, Journal Article, Observational Study)

Chemical References

• Bone Cements

Topics

• Adult
• Aged, 80 and over
• Bone Cements (therapeutic use)
• Bone Neoplasms (secondary, therapy)
• Breast Neoplasms
• Carcinoma, Renal Cell
• Cementoplasty (methods)
• Female
• Fluoroscopy (methods)
• Humans
• Liver Neoplasms
• Middle Aged
• Multiple Myeloma
• Osteolysis (therapy)
• Pain (prevention & control)
• Pain Management
• Pain Measurement
• Pressure
• Radiology, Interventional
• Stents
• Thyroid Neoplasms
• Tomography, X-Ray Computed (methods)
• Treatment Outcome
• Visual Analog Scale