Renal Angiomyolipoma: Long-term Results Following Selective Arterial Embolization

Ramon, Jacob; Rimon, Uri; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Kitrey, Noam D.; Nadu, Andrei; Dotan, Zohar

doi:10.1016/j.eururo.2008.04.025

Cited by 148 publications

(137 citation statements)

References 19 publications

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“…The small number of patients does not allow statistical analysis; however, size reduction rates were comparable between the two groups, as demonstrated in Figure 2, and maximum shrinkage (mean of 24%) was observed by 1 year with continued reduction demonstrated up to 3 years. We observed a mean size reduction of 36% at 4 years, which is comparable with a mean reduction rate that varied from 26% to 43%, as reported by other investigators [2,4,11,12]. However, the reduction rate at 36 months differed little from that at 48 months, which could imply the rate reaching a plateau.…”

Section: Discussionsupporting

confidence: 66%

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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: Discussionsupporting

confidence: 66%

“…Two further patients presented with rebleeding and underwent repeat embolisation, one from each group. Our overall retreatment rate (3/13, 23%) is well within the reported literature range of up to 37% [4,[7][8][9][10][11]. 77% of patients remain symptom-free and intervention-free after a median follow-up period of almost 4 years.…”

Section: Discussionsupporting

confidence: 63%

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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“…Renal AML is an uncommon benign tumor, and approximately 20% cases are associated with the TS complex [1][2][3][4]. Because it is benign in nature, asymptomatic cases can be managed by active surveillance [1,2].…”

Section: Discussionmentioning

confidence: 99%

“…The standard treatment option in symptomatic patients with AML is nephron-sparing surgery [1,2,5]. However, in the past two decades, selective arterial embolization (SAE) has been used as the first-line treatment option in patients presenting with acute bleeding as well as prophylactically to prevent future bleeding complications [3,6]. This case represents a successful embolization of giant renal AML with the combination of particular and liquid embolic agents.…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 20% of AMLs are associated with the tuberous sclerosis (TS) complex [1,2]. Because AMLs are usually asymptomatic, tumors of >4-cm diameter are usually symptomatic and present with retroperitoneal and/or urinary bleeding, which can be life threatening [1,3,4]. The standard treatment option in symptomatic patients with AML is nephron-sparing surgery [1,2,5].…”

Section: Introductionmentioning

confidence: 99%

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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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Kidney and Ureter Neoplasm

et al. 2019

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Renal Angiomyolipoma: Long-term Results Following Selective Arterial Embolization

Cited by 148 publications

References 19 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

Kidney and Ureter Neoplasm

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