{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:57:09Z","timestamp":1793746629882,"version":"4.6.1"},"reference-count":41,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":2235,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Surgery of long bone metastases is associated with a significant risk of perioperative blood loss, which may necessitate blood transfusion. Successful embolization (&amp;gt; 70% obliteration of vascularity) can be achieved in 36\u201375% of cases. The reported rate of embolization-related complications is 0\u20139%. Three out of six level III evidence studies showed a reduction in perioperative blood loss and\/or\u2009blood transfusion requirement after preoperative embolization of renal cell carcinoma\u2009metastasis in long bones; three out of six studies did not. One level III evidence study did not show a reduction in perioperative blood loss and\/or transfusion requirement after preoperative embolization of hepatocellular carcinoma metastases in long bones. There were no studies found that support preoperative embolization of thyroid metastases or other frequent long bone metastases (e.g. mamma carcinoma, lung carcinoma, or prostate carcinoma). The clinical level of evidence of the studies found is low and randomized studies taking into account primary tumour, location of metastases and type of surgery are therefore desired.<\/jats:p>\n                  <jats:p>Cite this article: EFORT Open Rev 2020;5:17-25. DOI: 10.1302\/2058-5241.5.190013<\/jats:p>","DOI":"10.1302\/2058-5241.5.190013","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T08:49:15Z","timestamp":1578041355000},"page":"17-25","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":39,"title":["Preoperative embolization in surgical treatment of long bone metastasis: a systematic literature review"],"prefix":"10.1530","volume":"5","author":[{"given":"Stijn E. W.","family":"Geraets","sequence":"first","affiliation":[{"name":"1Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Koen","family":"Bos","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"van der Stok","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2020,1,3]]},"reference":[{"key":"2026070711265553400_bibr1-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1002\/(SICI)1097-0142(19971015)80:8+<1614::AID-CNCR12>3.0.CO;2-2","article-title":"Orthopedic surgical management of skeletal complications of malignancy","volume":"80","author":"Harrington","year":"1997","journal-title":"Cancer"},{"key":"2026070711265553400_bibr2-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1053\/ctrv.2000.0210","article-title":"Metastatic bone disease: clinical features, pathophysiology and treatment strategies","volume":"27","author":"Coleman","year":"2001","journal-title":"Cancer Treat Rev"},{"key":"2026070711265553400_bibr3-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1038\/nrc867","article-title":"Metastasis to bone: causes, consequences and therapeutic opportunities","volume":"2","author":"Mundy","year":"2002","journal-title":"Nat Rev Cancer"},{"key":"2026070711265553400_bibr4-2058-5241.5.190013","first-page":"3279","article-title":"Natural history of skeletal-related events in patients with breast, lung, or prostate cancer and metastases to bone: a 15-year study in two large US health systems","volume":"21","author":"Oster","year":"2013","journal-title":"Support Care Cancer"},{"key":"2026070711265553400_bibr5-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1002\/cncr.22991","article-title":"Pathologic fractures correlate with reduced survival in patients with malignant bone disease","volume":"110","author":"Saad","year":"2007","journal-title":"Cancer"},{"key":"2026070711265553400_bibr6-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S1051-0443(96)70738-8","article-title":"Embolization of bone metastases","volume":"7","author":"Barton","year":"1996","journal-title":"J Vasc Interv Radiol"},{"key":"2026070711265553400_bibr7-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s00264-013-2108-x","article-title":"Benefits of early intramedullary nailing in femoral metastases","volume":"38","author":"Arvinius","year":"2014","journal-title":"Int Orthop"},{"key":"2026070711265553400_bibr8-2058-5241.5.190013","first-page":"302","article-title":"Mortality and complications following stabilization of femoral metastatic lesions: a population-based study of regional variation and outcome","volume":"52","author":"Ristevski","year":"2009","journal-title":"Can J Surg"},{"key":"2026070711265553400_bibr9-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"2343","DOI":"10.1007\/s11999-015-4167-3","article-title":"Are allogeneic blood transfusions associated with decreased survival after surgery for long-bone metastatic fractures?","volume":"473","author":"Janssen","year":"2015","journal-title":"Clin Orthop Relat Res"},{"key":"2026070711265553400_bibr10-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"3815","DOI":"10.1016\/j.arth.2017.06.054","article-title":"Transfusion thresholds for major orthopedic surgery: a systematic review and meta-analysis","volume":"32","author":"Mitchell","year":"2017","journal-title":"J Arthroplasty"},{"key":"2026070711265553400_bibr11-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1002\/jso.24345","article-title":"Outcome after fixation of metastatic proximal femoral fractures: a systematic review of 40 studies","volume":"114","author":"Janssen","year":"2016","journal-title":"J Surg Oncol"},{"key":"2026070711265553400_bibr12-2058-5241.5.190013","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-662-29279-2","volume-title":"Bone and soft tissue tumors","author":"Campanacci","year":"1990"},{"key":"2026070711265553400_bibr13-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"2026070711265553400_bibr14-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological index for non-randomized studies (minors): development and validation of a new instrument","volume":"73","author":"Slim","year":"2003","journal-title":"ANZ J Surg"},{"key":"2026070711265553400_bibr15-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1055\/s-2008-1032861","article-title":"Transcatheter embolization of tumors of the musculoskeletal system","volume":"156","author":"Reuter","year":"1992","journal-title":"Rofo"},{"key":"2026070711265553400_bibr16-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1089\/thy.2000.10.621","article-title":"Images in thyroidology. Embolization of a bone metastasis of follicular thyroid carcinoma","volume":"10","author":"van Tol","year":"2000","journal-title":"Thyroid"},{"key":"2026070711265553400_bibr17-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/00003086-198901000-00042","article-title":"Preoperative embolization in the treatment of osseous metastases from renal cell carcinoma","volume":"238","author":"Roscoe","year":"1989","journal-title":"Clin Orthop Relat Res"},{"key":"2026070711265553400_bibr18-2058-5241.5.190013","first-page":"55","article-title":"Embolization of bone metastases","volume":"35","author":"G\u00f6rich","year":"1995","journal-title":"Radiologe"},{"key":"2026070711265553400_bibr19-2058-5241.5.190013","first-page":"223","article-title":"Arterial embolization of bone metastases: is it worthwhile?","volume":"81","author":"Layalle","year":"1998","journal-title":"J Belge Radiol"},{"key":"2026070711265553400_bibr20-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s00270-003-0147-1","article-title":"Trisacryl gelatin microspheres versus polyvinyl alcohol particles in the preoperative embolization of bone neoplasms","volume":"27","author":"Basile","year":"2004","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2026070711265553400_bibr21-2058-5241.5.190013","first-page":"1641","article-title":"Embolization of benign and malignant bone and soft tissue tumors of the extremities","volume":"13","author":"B\u00f6r\u00fcban","year":"2007","journal-title":"Diagn Interv Radiol"},{"key":"2026070711265553400_bibr22-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1055\/s-0030-1253510","article-title":"Embolization of musculoskeletal bone tumors","volume":"27","author":"Owen","year":"2010","journal-title":"Semin Intervent Radiol"},{"key":"2026070711265553400_bibr23-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/00013611-200403000-00009","article-title":"Preoperative embolization of bone metastases","volume":"19","author":"Stephen","year":"2004","journal-title":"Tech Orthop"},{"key":"2026070711265553400_bibr24-2058-5241.5.190013","first-page":"87","article-title":"Arterial embolization as a therapeutic possibility of tumors of the skeletal system","volume":"24","author":"Bernd","year":"1994","journal-title":"Aktuelle Traumatol"},{"key":"2026070711265553400_bibr25-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/BF00241276","article-title":"Percutaneous transcatheter arterial embolization of bone and soft tissue tumors","volume":"19","author":"Rossi","year":"1990","journal-title":"Skeletal Radiol"},{"key":"2026070711265553400_bibr26-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1007\/s11547-011-0670-0","article-title":"Selective arterial embolisation for bone tumours: experience of 454 cases","volume":"116","author":"Rossi","year":"2011","journal-title":"Radiol Med (Torino)"},{"key":"2026070711265553400_bibr27-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1002\/jso.2930600214","article-title":"Preoperative embolization of osseous metastases from hypervascular cancers","volume":"60","author":"Miller","year":"1995","journal-title":"J Surg Oncol"},{"key":"2026070711265553400_bibr28-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"396","DOI":"10.3109\/02841851003660081","article-title":"Preoperative transcatheter arterial embolization of hypervascular metastatic tumors of long bones","volume":"51","author":"Kwon","year":"2010","journal-title":"Acta Radiol"},{"key":"2026070711265553400_bibr29-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s003300050969","article-title":"Preoperative embolization of bone metastases from renal cell carcinoma","volume":"10","author":"Chatziioannou","year":"2000","journal-title":"Eur Radiol"},{"key":"2026070711265553400_bibr30-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"W240","DOI":"10.2214\/AJR.07.4037","article-title":"Interventional management of hypervascular osseous metastasis: role of embolotherapy before orthopedic tumor resection and bone stabilization","volume":"191","author":"Kickuth","year":"2008","journal-title":"AJR Am J Roentgenol"},{"key":"2026070711265553400_bibr31-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"e99","DOI":"10.3928\/01477447-20150204-56","article-title":"Preoperative embolization for bone metastasis from hepatocellular carcinoma","volume":"38","author":"Kim","year":"2015","journal-title":"Orthopedics"},{"key":"2026070711265553400_bibr32-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1007\/s11999-014-3734-3","article-title":"Embolization of hypervascular bone metastases reduces intraoperative blood loss: a case-control study","volume":"472","author":"Pazionis","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"2026070711265553400_bibr33-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"183","DOI":"10.3109\/17453674.2015.1127726","article-title":"Surgery of non-spinal skeletal metastases in renal cell carcinoma: no effect of preoperative embolization?","volume":"87","author":"Ratasvuori","year":"2016","journal-title":"Acta Orthop"},{"key":"2026070711265553400_bibr34-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S1051-0443(98)70267-2","article-title":"Bone metastases from renal cell carcinoma: preoperative embolization","volume":"9","author":"Sun","year":"1998","journal-title":"J Vasc Interv Radiol"},{"key":"2026070711265553400_bibr35-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s11999.0000000000000058","article-title":"Not all patients undergoing stabilization of impending pathologic fractures for renal cell carcinoma metastases to the femur need preoperative embolization","volume":"476","author":"Jernigan","year":"2018","journal-title":"Clin Orthop Relat Res"},{"key":"2026070711265553400_bibr36-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"130","DOI":"10.2214\/ajr.123.1.130","article-title":"Selective intra-arterial embolization of bone tumors: a useful adjunct in the management of selected lesions","volume":"123","author":"Feldman","year":"1975","journal-title":"Am J Roentgenol Radium Ther Nucl Med"},{"key":"2026070711265553400_bibr37-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3928\/01477447-20110228-20","article-title":"Embolization of bone tumors","volume":"34","author":"Mavrogenis","year":"2011","journal-title":"Orthopedics"},{"key":"2026070711265553400_bibr38-2058-5241.5.190013","first-page":"156","article-title":"Results of preoperative embolization for metastatic spinal neoplasms","volume":"98","author":"Prabhu","year":"2003","journal-title":"J Neurosurg"},{"key":"2026070711265553400_bibr39-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.acra.2013.08.023","article-title":"Comparative accuracy of intravenous contrast-enhanced CT versus noncontrast CT plus intravenous contrast-enhanced CT in the detection and characterization of patients with hypervascular liver metastases: a critically appraised topic","volume":"21","author":"Sadigh","year":"2014","journal-title":"Acad Radiol"},{"key":"2026070711265553400_bibr40-2058-5241.5.190013","article-title":"Optimising the treatment of patients with long bone metastases","volume-title":"Orthopedic surgery","author":"Willeumier","year":"2018"},{"key":"2026070711265553400_bibr41-2058-5241.5.190013","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1136\/neurintsurg-2017-013350","article-title":"Systematic review and meta-analysis of effectiveness of preoperative embolization in surgery for metastatic spine disease","volume":"10","author":"Luksanapruksa","year":"2018","journal-title":"J Neurointerv Surg"}],"container-title":["EFORT Open Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/2058-5241.5.190013","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/2058-5241.5.190013","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.bioscientifica.com\/eor\/article-pdf\/5\/1\/17\/16960\/2058-5241.5.190013.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/eor\/article-pdf\/5\/1\/17\/16960\/2058-5241.5.190013.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:09:22Z","timestamp":1783440562000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/eor\/article\/5\/1\/17\/2196\/Preoperative-embolization-in-surgical-treatment-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,1]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,3]]},"published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.1302\/2058-5241.5.190013","relation":{},"ISSN":["2058-5241"],"issn-type":[{"value":"2058-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,1]]}}}