Preoperative embolization of bone metastases from renal cell carcinoma

The purpose of this study was to correlate the effectiveness of preoperativ e embolization with the blood loss and transfusion requirement during surge ry for bone metastases from renal cell carcinonoma. Twenty-eight preoperati ve embolizations in 26 patients with renal cell carcinoma metastatic to bon e were retrospectively evaluated and divided into two groups: Group A inclu ded the embolizations that resulted in complete devascularization of the le sion as defined by the post-embolization arteriograms, and group B included those with an incomplete result. The two groups were compared with regard to blood loss and transfusion requirement during surgery, by unpaired two-t ailed Student's t-test. Where complete embolization was effected (group A, 10 cases), there was a mean blood loss of 535 +/- 390 ml. When a less than complete embolization was achieved (group B, cases), the mean blood loss wa s 1.247 +/- 1.047 ml (p = 0.049). The red blood cell transfusion in group A was 1.3 +/- 1 units, whereas in group B it was 2.4 +/- 1.2 (p = 0.03). Pre operative embolization of bone metastases from renal cell carcinoma with su bsequent complete devascularization leads to significant reduction of blood loss during surgery. Interventional radiologists should pursue and emboliz e every feeder to the metastasis, because any less than complete devascular ization increases the amount of blood loss and the amount of red blood cell transfusion during surgery.