{
  "abstract": "Introduction Pre-operative embolisation in spinal metastases can reduce intraoperative blood loss, shorten surgical time, and aid recovery. However, in certain anatomical regions, such as the cervical spine, transarterial embolisation may pose high risks. Additionally, complex vascularity may preclude selective arterial access. Here we present two cases highlighting distinct scenarios where direct percutaneous embolisation was employed. These cases illustrate the technique and approach for safe and effective application of this method.Abstract C124 Figure 1Case Description Case 1: A patient in 70s with metastatic renal cell carcinoma presented with an L1 pathological fracture causing spinal cord compression. Angiography revealed no suitable dominant feeders for selective embolisation due to severe arterial stenosis and tortuosity. Under image guidance, direct percutaneous embolisation using Glubran-lipiodol mixture was performed, achieving good tumour devascularisation and retrograde occlusion of segmental arteries. Case 2: A patient in 60s with metastatic papillary thyroid carcinoma involving the C6-C7 spine. Angiogram demonstrated multiple arterial feeders supplying the tumour from bilateral upper-to-mid intercostal artery segmental branches and the thyrocervical trunk from left subclavian artery, which were embolized using coils and particles. This is followed by direct percutaneous injection of Glubran-lipiodol mixture into the C6-C7 tumour under cone-beam CT guidance, with satisfactory tumour devascularisation and no complications.Abstract C124 Figure 2Conclusions Direct percutaneous embolisation is a valuable technique in selected cases where transarterial access is limited or unsafe. Understanding anatomical constraints, precise image guidance, and careful technique are essential for effective tumour devascularisation and surgical optimisation.Abstract C124 Figure 3Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "National University Hospital, Singapore, Singapore"
      ],
      "name": "Si Zhao Tang"
    },
    {
      "affiliations": [
        "National University Hospital, Singapore, Singapore"
      ],
      "name": "Anil Gopinathan"
    }
  ],
  "title": "C124 Direct percutaneous embolisation in spinal metastases: a practical alternative in challenging vascular anatomy",
  "uid": "66959b56-4b34-59a1-9421-a6bdd0c45c23"
}