Rôle de l’embolisation dans les angiomyolipomes du rein

Dabbeche, C.; Chaker, M; Chemali, R.; Pérot, Vinçent; Hajj, L. El; Ferrière, J.; Ballanger, P; Chabbert, V.; Cimpean, A.; Otal, Philippe; Huyghe, É.; Grenier, N.; Joffre, F.

doi:10.1016/s0221-0363(06)74166-x

Cited by 36 publications

(30 citation statements)

References 11 publications

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“…SAE can be used for prophylaxis of high-risk tumor, for acute management of tumor bleeding, or as a preoperative adjunct treatment for surgery to prevent intraoperative blood loss (8,20,24,25). This minimally invasive interventional radiology technique has become the primary treatment for AMLs since several years because it is less invasive than a surgical intervention and enables targeted treatment of bleeding vessels with a low risk of severe complications (20,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). The objective of this retrospective mono-centric study was to present our 11-year experience with planned prophylactic and emergency SAE of renal AMLs by reviewing our institution's series of 23 patients and evaluating complications, outcomes and tumor size reduction (TSR) after SAE.…”

Section: Introductionmentioning

confidence: 99%

Selective arterial embolization of symptomatic and asymptomatic renal angiomyolipomas: a retrospective study of safety, outcomes and tumor size reduction

Bardin¹,

Chevallier²,

Bertaut³

et al. 2017

Quant. Imaging Med. Surg.

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Background: Angiomyolipoma (AML) is the most common renal benign tumor. Treatment should be considered for symptomatic patients or for those at risk for complications, especially retroperitoneal bleeding which is correlated to tumor size, grade of the angiogenic component and to the presence of tuberous sclerosis complex (TSC). This study reports our single-center experience with the use of selective arterial embolization (SAE) in the management of symptomatic and asymptomatic renal AMLs. Methods:In this retrospective mono-centric study, all demographic and imaging data, medical records, angiographic features, outpatient charts and follow-up visits of patients who underwent prophylactic or emergency SAE for AMLs between January 2005 and July 2016 were reviewed. Tumor size and treatment outcomes were assessed at baseline and after the procedure during follow-up. Computed tomography (CT), magnetic resonance imaging (MRI) or ultrasonography was used to evaluate AML shrinkage. Renal function was measured pre-and post-procedure.Results: Twenty-three patients (18 females, 5 males; median age, 45 years; range, 19-85 years) who underwent SAE either to treat bleeding AML (n=6) or as a prophylactic treatment (n=17) were included.Overall, 34 AMLs were embolized. TSC status was confirmed for 6 patients. Immediate technical success rate was 96% and 4 patients benefitted from an additional procedure. Major complications occurred in 3 patients and minor post-embolization syndrome (PES) in 14 patients. The mean AML size reduction rate was 26.2% after a mean follow-up was 20.5 months (range, 0.5-56 months), and only non-TSC status was significantly associated with better shrinkage of tumor (P=0.022). Intralesional aneurysms were significantly more frequent in patients with hemorrhagic presentation (P=0.008). There was no change in mean creatinine level after SAE.Conclusions: SAE is a safe and effective technique to manage renal AMLs as a preventive treatment as well as in emergency setting, with significant reduction in tumor size during follow-up. A multidisciplinary approach remains fundamental, especially for TSC patients. In addition to size, the presence of intralesional aneurysms should be considered in any prophylactic treatment decision.

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Section: Introductionmentioning

confidence: 99%

Selective arterial embolization of symptomatic and asymptomatic renal angiomyolipomas: a retrospective study of safety, outcomes and tumor size reduction

Bardin¹,

Chevallier²,

Bertaut³

et al. 2017

Quant. Imaging Med. Surg.

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“…Different embolic agents have been described in the literature such as polyvinyl alcohol particles, ethanol, microspheres, gelfoam and coils [10,17,18]. However, previous studies using the same embolic agents as used here (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…However, previous studies using the same embolic agents as used here (i.e. microspheres and coils) did not assess the complications observed for each embolic agent [10,17,18]. Recent guidelines recommend the use of microspheres with a diameter of more than 500 m to avoid leakage through intratumoral arteriovenous shunts [14,15,28].…”

Section: Discussionmentioning

confidence: 99%

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Tumor necrosis after preventive embolization of large renal angiomyolipomas

Rafei

Renard

Puech

et al. 2015

Diagnostic and Interventional Imaging

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“…L'efficacité technique et clinique des embolisations d'hémostase et préventive a été démontrée dans plusieurs études [16][17][18]. Les complications post-embolisation pré-ventive notamment la nécrose lésionnelle sont rares [10].…”

Section: Introductionunclassified