BACKGROUND: Preoperative transcatheter arterial embolization (P-TAE) is a procedure designed to reduce intraoperative blood loss (IBL) and support the performance of surgery for bone and soft tissue tumors (BSTT). PURPOSE: To develop a new P-TAE technique using a triaxial microcatheter system (TMCS) that maintains normal tissue circulation while embolizing only the feeding artery of BSTT and to investigate the safety and efficacy of P-TAE with TMCS. MATERIAL AND METHODS: A total of 34 cases of BSTT in the whole body (25 men, nine women
mean age = 74.85 ± 11.32 years) were included between 1 April 2014 and 30 June 2024. We evaluated technical and clinical outcomes, P-TAE techniques, complications, and patient characteristics. RESULTS: Bone metastasis of renal cell carcinoma (n = 11) was the most frequent diagnosis. P-TAEs using TMCS were performed with technical success (97.05%) and clinical success (88.23%), demonstrating a high selectivity rate to the feeding artery of 97.14%. The mean IBL was 792.70 ± 1285.61 mL (median = 370 mL
range = 50-6935 mL). All surgeries were performed successfully after P-TAE. CONCLUSION: P-TAE plays an important role in the presurgical operation of BSTT. The use of TMCS offers high selectivity, trackability, and crossability in the P-TAE procedure, enhancing the clinical efficacy of P-TAE.