Combination Therapy Using Embolization, Gelified Alcohol Sclerotherapy, and Vertebroplasty to Treat Aggressive Vertebral Hemangioma: Technique and Initial Results

Sylvain Grange; Thierry Thomas; Lucile Grange; Hubert Marotte; Jean-Baptiste Pelletier; Stacoffe Nicolas; Rémi Grange

doi:10.1016/j.jvir.2025.06.006

Combination Therapy Using Embolization, Gelified Alcohol Sclerotherapy, and Vertebroplasty to Treat Aggressive Vertebral Hemangioma: Technique and Initial Results

J Vasc Interv Radiol. 2025 Jun 23:S1051-0443(25)00414-2. doi: 10.1016/j.jvir.2025.06.006. Online ahead of print.

Authors

Sylvain Grange¹, Thierry Thomas², Lucile Grange³, Hubert Marotte², Jean-Baptiste Pelletier⁴, Stacoffe Nicolas⁵, Rémi Grange⁶

Affiliations

¹ Department of Radiology, University Hospital of Saint Etienne, Avenue Albert Raymond, 42055 Saint-Etienne cedex 2 France. Electronic address: sylvain.grange@chu-st-etienne.fr.
² Department of Rhumatology, University Hospital of Saint Etienne, Avenue Albert Raymond, 42055 Saint-Etienne cedex 2 France.
³ Department of Internal Medicine, University Hospital of Saint Etienne, Avenue Albert Raymond, 42055 Saint-Etienne cedex 2 France.
⁴ Department of Neurosurgery, University Hospital of Saint Etienne, Avenue Albert Raymond, 42055 Saint-Etienne cedex 2 France.
⁵ Department of Radiology, Groupement Hospitalier Sud, Hospice Civils de Lyon, Pierre-Bénite, France.
⁶ Department of Radiology, University Hospital of Saint Etienne, Avenue Albert Raymond, 42055 Saint-Etienne cedex 2 France.

PMID: 40562307
DOI: 10.1016/j.jvir.2025.06.006

Abstract

The aim was to evaluate technical success, safety and effectiveness of a non-surgical protocol treatment combining transarterial embolization and percutaneous radiopaque gelified ethanol (RGE) sclerotherapy in a first procedure, followed by vertebroplasty in a second procedure, to treat patients with aggressive vertebral hemangioma (AVH). This retrospective study included a total of 10 patients treated for hemangiomas between September 2022 and March 2024. The 11 hemangiomas were located in the cervical (n=1), thoracic (n=5), lumbar (n=4) or sacrum (n=1). Follow-up included MRIs and medical consultations one year after the final procedure. In all cases, the procedure was technically feasible. The procedure was safe; one fracture occurred between sclerosis and cementoplasty, probably partly related to the AVH. This procedure proved to be effective, as in all patients, the epiduritis partially regressed on follow-up MRI. 90% of patients noted a reduction or disappearance of pain.