Palliative Arterial Embolization for Metastases of the Sternum

Abstract

Background: To investigate the safety and efficacy of palliative arterial embolization for metastases of the sternum.

Materials and methods: This study included 10 consecutive patients (5 M, 5 F; mean age 58.1; range 37-70) with metastases of the sternum from different primary tumors, treated with palliative arterial embolization using NBCA-Lipiodol between January 2007 and June 2022. Four patients received a second embolization at the same site, for a total of 14 embolizations. Data on technical and clinical success, as well as changes in tumor size, were collected. All embolization-related complications were evaluated according to the CIRSE classification system for complications.

Results: Post-embolization angiography showed occlusion of more than 90% of the pathological feeding vessels in all procedures. Pain score and analgesic drug consumption were reduced by 50% in all 10 patients (100%, p < 0.05). The mean duration of pain relief was 9.5 months (range 8 to 12 months, p < 0.05). Metastatic tumor size was reduced from a mean of 71.5 cm³ (range 41.6 to 90.3 cm³) pre-embolization to a mean of 67.9 cm³ (range 38.5 to 86.1 cm³) at the 12-month follow-up (p < 0.05). None of the patients experienced embolization-related complications.

Conclusion: Arterial embolization is safe and effective as a palliative treatment for patients with metastases of the sternum who did not benefit from radiation therapy or experienced recurrence in symptoms.

Keywords: Embolization; Metastasis; Pain; Palliation; Sternum.