The purpose of this chapter is to review the clinical features, imaging characteristics, and treatment of various vascular spinal tumors that may benefit from endovascular embolization and then to discuss the principles and technical details of spinal angiography and spinal tumor embolization. Vascular spinal tumors amenable to embolization include hemangioblastomas, hemangiomas, anuerysmal bone cysts, osteoid osteomas, osteoblastomas, giant cell tumors, and metastases, among others. Embolization can be used pre-operatively to reduce blood loss or primarily to reduce pain or prevent tumor progression. Various embolic agents are available including liquid agents such as Onyx (Micro Therapeutics, Inc.) and n-butyl-2-cyanoacrylate (NBCA; Histoacryl, B. Braun, Melsungen, Germany) as well as particulate agents such as polyvinyl alcohol (PVA) and Embospheres (Guerbet Biomedical). Spinal tumor embolization should maximally occlude pathologic tumor supplying vessels while preserving normal blood supply to the spinal cord. Safe and effective endovascular treatment thus depends on careful attention to the relevant angiographic anatomy and technique.
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Acosta F, Sanai N, Chi J, Dowd C, Chin C, Tihan T, Chou D, Weinstein PR, Ames CP (2008) Comprehensive management of symptomatic and aggressive vertebral hemangiomas. Neurosurg Clin N Am 19(1):17–29PubMedCrossRefGoogle Scholar
Berenstein A, Lasjuanias P, Ter Brugge K (2004) Tumors of the spinal column and spinal cord. In: Berenstein A, Lasjuanias P, Ter Brugge K (eds) Surgical neuroangiography, vol 2.2. Springer, New York, pp 873–909CrossRefGoogle Scholar
Chaloupka J, Vinuela F, Vinters H, Robert J (1994) Technical feasibility and histopathologic studies of ethylene vinyl copolymer (EVAL) using swine endovascular embolization model. AJNR Am J Neuroradiol 15(6):1107–1115PubMedGoogle Scholar
Choi I, Tantivatana J (2000) Neuroendovascular management of intracranial and spinal tumors. Neurosurg Clin N Am 11:167–185PubMedGoogle Scholar
Chuang V, Soo C, Wallace S, Benjamin R (1981) Arterial occlusion: management of giant cell tumor and aneurysmal bone cyst. AJR 136:1127–1130PubMedGoogle Scholar
Djindjian R, Merland J, Djindjian M, Soteter P (1981) Angiography of spinal column and spinal cord tumors. Neuroradiologic atlas, Thieme, New YorkGoogle Scholar
Elhammady M, Wolfe S, Ashour R, Farhat H, Moftakhar R, Lieber B, Aziz-Sultan M (2010) Safety and efficacy of vascular tumor embolization using Onyx: is angiographic devascularization sufficient? J Neurosurg 112(5):1039–1045PubMedCrossRefGoogle Scholar
Gobin Y, Murayama Y, Milanese K, Chow K, Gonzalez N, Duckwiler G, Vinuela F (2001) Head and neck hypervascular lesions: embolization with ethylene vinyl alcohol copolymer–laboratory evaluation in swine and clinical evaluation in humans. Radiology 221(2):309–317PubMedCrossRefGoogle Scholar
Hosalkar H, Jones K, King J, Lackman R (2007) Serial arterial embolization for large sacral giant-cell tumors: mid- to long-term results. Spine 32(10):1107–1115PubMedCrossRefGoogle Scholar
Murugesan C, Saravanan S, Rajkumar J, Prasad J, Banakal S (2008) Severe pulmonary oedema following therapeutic embolization with onyx for cerebral arteriovenous malformation. Neuroradiology 50:439–442PubMedCrossRefGoogle Scholar