Aneurysmal bone cysts (ABCs) are rare and poorly understood bony lesions. ABCs are intensely vascularized by both high flow vessels and low flow “vascular lakes”.Owing to this features treating an ABC can often be difficult and perilous since abrupt hemorrhages can occur. Besides, enucleation or courettage are frequently blemished by local recurrence.Resection with reconstruction (often after previous embolization) is an option that yields higher cure rate but at the price of disfigurement or donor site morbidity.Here we report a preliminary analysis of a new technique that consist on endovascular embolization followed by percutaneous alcoholization and obliteration by injecting liquid hydroxylapathite into the vascular chambers. Two patients, who were previously treated with conservative surgical removal of mandibular ABC, presented with vast recurrences.Under general anesthesia an endovascular procedure was undertaken. Here facial and inferior alveolar arteries were closed by means of cyanoacrilic glue. Then by percutaneous direct puncture the remaining “vascular lakes” were injected with absolute alcohol. Ten minutes after, when a fluoroscopic examination demonstrated no contrast leakage, liquid hydroxylapathite was injected into the chambers.No perioperative complications were recorded.Six months after the procedure no disease relapse was detectable.5 more patients with ABC outside the facial skeleton were treated with the same technique.Endovascular treatment followed by percutaneous injection of calcium hydroxylapathite seems to be a valid alternative to safely and conservatively manage ABCs.However longer follow up and higher number of treated patients are needed to deem this approach superior to the “standard” resection.

Aneurysmal bone cyst: effective nonsurgical treatment based on embolization, percutaneous alcoholization and injection of liquid hydroxyapatite / C. Gandolfo, G. Colletti, F. Giovanditto, M. Cucurullo, F. Allevi, D. Rabbiosi, M. Pedrazzoli, F. Biglioli. ((Intervento presentato al 23. convegno EACMFS tenutosi a London nel 2016.

Aneurysmal bone cyst: effective nonsurgical treatment based on embolization, percutaneous alcoholization and injection of liquid hydroxyapatite

G. Colletti
Secondo
;
F. Allevi;F. Biglioli
2016

Abstract

Aneurysmal bone cysts (ABCs) are rare and poorly understood bony lesions. ABCs are intensely vascularized by both high flow vessels and low flow “vascular lakes”.Owing to this features treating an ABC can often be difficult and perilous since abrupt hemorrhages can occur. Besides, enucleation or courettage are frequently blemished by local recurrence.Resection with reconstruction (often after previous embolization) is an option that yields higher cure rate but at the price of disfigurement or donor site morbidity.Here we report a preliminary analysis of a new technique that consist on endovascular embolization followed by percutaneous alcoholization and obliteration by injecting liquid hydroxylapathite into the vascular chambers. Two patients, who were previously treated with conservative surgical removal of mandibular ABC, presented with vast recurrences.Under general anesthesia an endovascular procedure was undertaken. Here facial and inferior alveolar arteries were closed by means of cyanoacrilic glue. Then by percutaneous direct puncture the remaining “vascular lakes” were injected with absolute alcohol. Ten minutes after, when a fluoroscopic examination demonstrated no contrast leakage, liquid hydroxylapathite was injected into the chambers.No perioperative complications were recorded.Six months after the procedure no disease relapse was detectable.5 more patients with ABC outside the facial skeleton were treated with the same technique.Endovascular treatment followed by percutaneous injection of calcium hydroxylapathite seems to be a valid alternative to safely and conservatively manage ABCs.However longer follow up and higher number of treated patients are needed to deem this approach superior to the “standard” resection.
set-2016
Settore MED/29 - Chirurgia Maxillofacciale
Aneurysmal bone cyst: effective nonsurgical treatment based on embolization, percutaneous alcoholization and injection of liquid hydroxyapatite / C. Gandolfo, G. Colletti, F. Giovanditto, M. Cucurullo, F. Allevi, D. Rabbiosi, M. Pedrazzoli, F. Biglioli. ((Intervento presentato al 23. convegno EACMFS tenutosi a London nel 2016.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/474585
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