RT Journal Article
SR Electronic
T1 Percutaneous alcohol embolization and vertebroplasty of a T2 aggressive vertebral hemangioma with prior embolization of dangerous arterial anastomoses
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP neurintsurg-2022-019036
DO 10.1136/jnis-2022-019036
A1 Baptiste Bonnet
A1 Eimad Shotar
A1 Kevin Premat
A1 Evelyne Cormier
A1 Adrien Beth
A1 Hugo Trebern
A1 Jugurtha Mahtout
A1 Antoine Feydy
A1 Frédéric Clarençon
YR 2022
UL http://jnis.bmj.com/content/early/2022/07/13/jnis-2022-019036.abstract
AB 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