Role of preoperative embolization for intradural spinal hemangioblastomas

Leonel Ampie, Winward Choy, Ryan Khanna, Zachary A. Smith, Nader S. Dahdaleh, Andrew T. Parsa, Orin Bloch

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Spinal hemangioblastomas (HB) are relatively rare neoplasms with a high degree of vascularity. Therapy for symptomatic tumors involves total resection when possible. Due to the enriched blood supply of these neoplasms, there is a high risk of significant intraoperative blood loss, which can lead to perioperative complications. Preoperative embolization of HB has been suggested to reduce blood loss and operative morbidity, but its use remains controversial. Data on the risks and benefits of preoperative embolization for this tumor remains limited. We identified and analyzed all 29 reported cases of preoperative embolization of intradural spinal HB within the literature. There were 18 men and nine women, and patients ranged from 24 to 61 years of age. Mean tumor size was 3.5 cm. Cervical and thoracic location was most common, accounting for 48.3% and 20% of cases, respectively. Complications from embolization and surgery were minimal, with no deaths or permanent neurological morbidity. Minimal intraoperative bleeding and excellent rates of gross total resection were reported with preoperative embolization. However, outcomes from microsurgery alone from historical series have similarly reported excellent outcomes. While there is no established standard, preoperative embolization should be reserved for particularly high risk patients with risk of intraoperative bleeding.

Original languageEnglish (US)
Pages (from-to)83-87
Number of pages5
JournalJournal of Clinical Neuroscience
Volume24
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Fingerprint

Hemangioblastoma
Neoplasms
Hemorrhage
Morbidity
Microsurgery
Thorax

Keywords

  • Embolization
  • Hemangioblastoma
  • Intradural
  • Preoperative
  • Spinal

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Role of preoperative embolization for intradural spinal hemangioblastomas. / Ampie, Leonel; Choy, Winward; Khanna, Ryan; Smith, Zachary A.; Dahdaleh, Nader S.; Parsa, Andrew T.; Bloch, Orin.

In: Journal of Clinical Neuroscience, Vol. 24, 01.02.2016, p. 83-87.

Research output: Contribution to journalArticle

Ampie, Leonel ; Choy, Winward ; Khanna, Ryan ; Smith, Zachary A. ; Dahdaleh, Nader S. ; Parsa, Andrew T. ; Bloch, Orin. / Role of preoperative embolization for intradural spinal hemangioblastomas. In: Journal of Clinical Neuroscience. 2016 ; Vol. 24. pp. 83-87.
@article{fd39752e93be410688e0ad7015c1e08c,
title = "Role of preoperative embolization for intradural spinal hemangioblastomas",
abstract = "Spinal hemangioblastomas (HB) are relatively rare neoplasms with a high degree of vascularity. Therapy for symptomatic tumors involves total resection when possible. Due to the enriched blood supply of these neoplasms, there is a high risk of significant intraoperative blood loss, which can lead to perioperative complications. Preoperative embolization of HB has been suggested to reduce blood loss and operative morbidity, but its use remains controversial. Data on the risks and benefits of preoperative embolization for this tumor remains limited. We identified and analyzed all 29 reported cases of preoperative embolization of intradural spinal HB within the literature. There were 18 men and nine women, and patients ranged from 24 to 61 years of age. Mean tumor size was 3.5 cm. Cervical and thoracic location was most common, accounting for 48.3{\%} and 20{\%} of cases, respectively. Complications from embolization and surgery were minimal, with no deaths or permanent neurological morbidity. Minimal intraoperative bleeding and excellent rates of gross total resection were reported with preoperative embolization. However, outcomes from microsurgery alone from historical series have similarly reported excellent outcomes. While there is no established standard, preoperative embolization should be reserved for particularly high risk patients with risk of intraoperative bleeding.",
keywords = "Embolization, Hemangioblastoma, Intradural, Preoperative, Spinal",
author = "Leonel Ampie and Winward Choy and Ryan Khanna and Smith, {Zachary A.} and Dahdaleh, {Nader S.} and Parsa, {Andrew T.} and Orin Bloch",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.jocn.2015.09.006",
language = "English (US)",
volume = "24",
pages = "83--87",
journal = "Journal of Clinical Neuroscience",
issn = "0967-5868",
publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Role of preoperative embolization for intradural spinal hemangioblastomas

AU - Ampie, Leonel

AU - Choy, Winward

AU - Khanna, Ryan

AU - Smith, Zachary A.

AU - Dahdaleh, Nader S.

AU - Parsa, Andrew T.

AU - Bloch, Orin

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Spinal hemangioblastomas (HB) are relatively rare neoplasms with a high degree of vascularity. Therapy for symptomatic tumors involves total resection when possible. Due to the enriched blood supply of these neoplasms, there is a high risk of significant intraoperative blood loss, which can lead to perioperative complications. Preoperative embolization of HB has been suggested to reduce blood loss and operative morbidity, but its use remains controversial. Data on the risks and benefits of preoperative embolization for this tumor remains limited. We identified and analyzed all 29 reported cases of preoperative embolization of intradural spinal HB within the literature. There were 18 men and nine women, and patients ranged from 24 to 61 years of age. Mean tumor size was 3.5 cm. Cervical and thoracic location was most common, accounting for 48.3% and 20% of cases, respectively. Complications from embolization and surgery were minimal, with no deaths or permanent neurological morbidity. Minimal intraoperative bleeding and excellent rates of gross total resection were reported with preoperative embolization. However, outcomes from microsurgery alone from historical series have similarly reported excellent outcomes. While there is no established standard, preoperative embolization should be reserved for particularly high risk patients with risk of intraoperative bleeding.

AB - Spinal hemangioblastomas (HB) are relatively rare neoplasms with a high degree of vascularity. Therapy for symptomatic tumors involves total resection when possible. Due to the enriched blood supply of these neoplasms, there is a high risk of significant intraoperative blood loss, which can lead to perioperative complications. Preoperative embolization of HB has been suggested to reduce blood loss and operative morbidity, but its use remains controversial. Data on the risks and benefits of preoperative embolization for this tumor remains limited. We identified and analyzed all 29 reported cases of preoperative embolization of intradural spinal HB within the literature. There were 18 men and nine women, and patients ranged from 24 to 61 years of age. Mean tumor size was 3.5 cm. Cervical and thoracic location was most common, accounting for 48.3% and 20% of cases, respectively. Complications from embolization and surgery were minimal, with no deaths or permanent neurological morbidity. Minimal intraoperative bleeding and excellent rates of gross total resection were reported with preoperative embolization. However, outcomes from microsurgery alone from historical series have similarly reported excellent outcomes. While there is no established standard, preoperative embolization should be reserved for particularly high risk patients with risk of intraoperative bleeding.

KW - Embolization

KW - Hemangioblastoma

KW - Intradural

KW - Preoperative

KW - Spinal

UR - http://www.scopus.com/inward/record.url?scp=84954075149&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84954075149&partnerID=8YFLogxK

U2 - 10.1016/j.jocn.2015.09.006

DO - 10.1016/j.jocn.2015.09.006

M3 - Article

C2 - 26585384

AN - SCOPUS:84954075149

VL - 24

SP - 83

EP - 87

JO - Journal of Clinical Neuroscience

JF - Journal of Clinical Neuroscience

SN - 0967-5868

ER -