Embolization of Renal Angiomyolipomas: Short-Term and Long-Term Outcomes, Complications, and Tumor Shrinkage

Lee, Shen‐Yang; Hsu, Hsiang-Hao; Chen, Yung‐Chang; Huang, Chung‐Cheng; Wong, Yon-Cheong; Wang, Li-Jen; Chuang, Cheng-Keng; Yang, Chih‐Wei

doi:10.1007/s00270-009-9637-0

Cited by 58 publications

(73 citation statements)

References 26 publications

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“…The AML that required repeat embolisation in our series reduced only 6.5% after 1 year and subsequently exhibited regrowth after 4 years. Lee et al [13] also recently showed mean AML size reduction of 33% and 43% at short-term (,6 months) and long-term (.6 months) follow-up, and that tumour shrinkage occurring within 6 months after the procedure may reflect the long-term effects of embolisation. As suggested by Kothary et al [4] patients with TS may behave differently and require lifelong follow-up given the propensity for recurrence and multifocal disease.…”

Section: Discussionmentioning

confidence: 99%

Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Patatas¹,

Robinson²,

Ettles³

et al. 2013

BJR

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Results: 13 patients underwent 16 episodes of embolisation. Coils were used as the primary embolisation material in 10 episodes and microspheres in 6 episodes. The size reduction rate highly correlated on CT followup between the two groups, with 25.6% vs 22.7% reduction at 12 months, 27.5% vs 25.1% at 24 months, 35.0% vs 33.0% at 36 months and 35.0% vs 36.8% at 48 months. During follow-up, all tumours reduced in size with one patient requiring subsequent embolisation whose tumour reduced by only 6.5% after 1 year and subsequently exhibited regrowth after 4 years. Two patients presented with rebleeding and underwent repeat embolisation. Our overall retreatment rate (23%) is well within the literature range (up to 37%). None of the patients underwent surgery. Conclusion:The majority of AML shrinkage occurs within the first year following embolisation and appears to plateau after 3 years, which could have an impact on follow-up strategy. The percentage reduction at 1 year may reflect the long-term effect of embolisation with tumours demonstrating minor size reduction more likely to relapse at long-term follow-up. Embolisation of renal AML produces durable long-term results regardless of the choice of embolic agent. Advances in knowledge:These findings provide information to guide CT follow-up of renal AML post embolisation.

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Section: Discussionmentioning

confidence: 99%

Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Patatas¹,

Robinson²,

Ettles³

et al. 2013

BJR

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show abstract

“…The mean AML size reduction was 26.2% after mean 20.5 months of follow-up. Lee et al [12] also have recently showed that the mean AML size reduction was between 33% and 43% within and after 6 months follow-up, respectively. In the present case, mean 59% tumor size reduction was observed within 5 months follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…In experienced hands, glue provides a very fast and effective distal embolization with a high dilution of lipiodol (glue:lipiodol ratio, 1:3-1:6). Glue is a very effective embolic agent for the management of acute hemorrhages, aneurysms, arteriovenous malformations, and fistulas [5,12]. In the present case, initially non-calibrated 355-to 500-mm PVA particles were used to occlude the distal vascular bed.…”

Section: Discussionmentioning

confidence: 99%

Selective Arterial Embolization of Giant Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex Using Particular and Liquid Embolic Agents

Kocakgol

Cayli²,

Oguz

et al. 2018

Eurasian J Med

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Renal angiomyolipoma (AML) is a benign hamartomatous tumor that is sometimes associated with the tuberous sclerosis complex. We report a 23-year-old man who presented with acute abdominal pain and hematuria. Computed tomography (CT) revealed large heterogeneous right renal mass of 17×13×13-cm diameter, consistent with AML, and acute and subacute hemorrhages. Digital subtraction angiography revealed massive tumor vascularization and multiple aneurysms associated with right renal artery branches. First, polyvinyl alcohol particles were used for the selective embolization of AML. Then, N-butyl cyanoacrylate (glue) mixed with lipiodol in a 1:3 ratio was injected for the permanent embolization of AML. CT scan revealed 59% reduction in size at 5 months after embolization. This case illustrates the selective embolization of giant renal AML with the combination of particular and liquid embolic agents with a significant reduction in size during the follow-up period.

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“…5,9,11 Embolization is done with PVA particles and coils. 4,5 However, use of PVA particles alone is associated with higher incidence of post-procedure tumor bleed. 4 This procedure has a low failure rate, is generally associated with acceptable complications, low-morbidity and no mortality.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 However, use of PVA particles alone is associated with higher incidence of post-procedure tumor bleed. 4 This procedure has a low failure rate, is generally associated with acceptable complications, low-morbidity and no mortality. 5,6,10 Follow-up shows good response with average size reduction of about 40 percent 6,10 and well preserved renal function.…”

Section: Discussionmentioning

confidence: 99%

Emergency embolization of actively bleeding renal angiomyolipoma in a patient of tuberous sclerosis

et al. 2014

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Renal angiomyolipoma is a benign hamartomatous lesion which contains varying proportions of abnormal blood vessels along with muscle and fat component. Tuberous sclerosis predisposes to angiomyolipoma, and when associated, the lesion is often large with increased risk of hemorrhage and complications. When this occurs, transarterial embolization and surgery are the treatment options. Such a patient presented to us with acute onset of symptoms, and on account of severe anemia with active bleeding, transarterial embolization was performed. This was followed by elective nephrectomy without any complications. We present the imaging aspects of tuberous sclerosis and emphasize role of interventional radiology in this case.

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Embolization of Renal Angiomyolipomas: Short-Term and Long-Term Outcomes, Complications, and Tumor Shrinkage

Cited by 58 publications

References 26 publications

Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Selective Arterial Embolization of Giant Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex Using Particular and Liquid Embolic Agents

Emergency embolization of actively bleeding renal angiomyolipoma in a patient of tuberous sclerosis

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