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.