Bone metastases from renal carcinoma. The preoperative use of transcatheter arterial occlusion.

Surgical treatment of hypervascular bone lesions can result in excessive operative blood loss. We reviewed the cases of eight patients who were operated on for hypervascular bone metastases from renal carcinoma after preoperative transcatheter embolization. The embolization was successful in six of these patients and their operative blood loss averaged only 550 milliliters (range, 450 to 750 milliliters). The reasons for failure in two patients were failure to recognize and embolize all major vessels supplying the tumor in the first and the presence of too many small vessels arising directly from the superficial femoral artery to embolize safely in the second. When surgical treatment of hypervascular bone metastases is indicated, consideration should be given to preoperative arterial embolization.