How effective is embolization with N-2-butyl-cyanoacrylate for aneurysmal bone cysts?

Area of Science:

• Interventional Radiology
• Orthopedic Surgery
• Vascular Surgery

Background:

• Aneurysmal bone cysts (ABCs) are benign, expansile bone lesions that can cause significant pain and structural damage.
• Traditional treatment options for ABCs include surgical curettage and bone grafting, which can be associated with high recurrence rates and morbidity.
• Selective arterial embolization has emerged as a less invasive alternative for managing ABCs, aiming to reduce blood flow to the lesion.

Purpose of the Study:

• To evaluate the efficacy and safety of selective arterial embolization using N-2-butyl-cyanoacrylate for treating aneurysmal bone cysts.
• To assess healing rates, recurrence patterns, and complications associated with this embolization technique.
• To analyze factors influencing treatment outcomes, including patient age, lesion size, and location.

Main Methods:

• A retrospective study of 102 patients diagnosed with aneurysmal bone cysts.
• Patients underwent embolization treatment using N-2-butyl-cyanoacrylate as the embolic agent.
• Outcomes including technical feasibility, lesion healing, recurrence, complications, and procedural costs were evaluated over a mean follow-up of seven years.

Main Results:

• Embolization was technically feasible in 86.3% of patients.
• Complete healing was achieved in 81.8% of patients after one to three embolization sessions.
• Recurrences occurred in 18.2% of patients, primarily in younger individuals and larger cysts (>6 cm). Complications were infrequent (4.5%).

Conclusions:

• Selective arterial embolization with N-2-butyl-cyanoacrylate is an effective treatment for aneurysmal bone cysts, demonstrating good healing rates and low complication incidence.
• The procedure requires significant operator experience, technical proficiency, and thorough knowledge of regional vascular anatomy for optimal results.
• Embolization offers a viable, minimally invasive option for managing ABCs, particularly when considering recurrence rates and patient morbidity associated with surgical interventions.