Transcatheter Renal Artery Embolization: Clinical Applications and Techniques

Ginat, Daniel Thomas; Saad, Wael E.A.; Turba, Ulku C.

doi:10.1053/j.tvir.2009.09.007

Cited by 100 publications

(100 citation statements)

References 45 publications

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“…However, we're using more and more N-butyl 2-cyanoacrylate glue (Glubran 2 ® ) for SAE these last years. Property of glue for arterial occlusion is mostly seen in lesions supplied by end-arteries; as a consequence, intra-parenchymal tumors or vascular lesions with end-artery feeders such as AMLs are suitable for glue application, with the expectation of a sclerosis of the tumor and a total devascularization of the vascular bed (77). Advantages of glue are that it works instantly, provides fast and distal embolization with high dilution of lipiodol (ratio, glue:lipiodol >1:5), completely occludes vessels and is permanent (78).…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…A embolização arterial renal é um procedimento adjuvante na medicina atual, sendo sua principal indicação a embolização de massas, antes da realização da nefrectomia (7,8); no entanto, tornou-se uma alternativa importante para o manejo da hipertensão arterial resistente no contexto da doença renal crônica terminal (9). Neste grupo de pacientes é sabido que a hipertensão é atribuida não apenas a um estado hiperreninêmico (4), mas também um estado de atividade simpática aumentada (5).…”

Section: Discussionunclassified

Embolização de artérias renais para o tratamento da hipertensão arterial não controlada

Naranjo-Restrepo¹,

Montejo-Hernández

2016

CES Med

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“…That patient, whose rAVM was treated with Onyx, had underwent coil embolization for the traumatic arteriovenous fistula 8 years before the diagnosis of the rAVM. As a result, liquid embolic materials are preferred over coils for the treatment of rAVMs (5). Earlier reports on endovascular treatment of rAVMs describe embolization with liquid embolic materials, such as acrylic glue (n-butyl-cyano-acrylate, nBCA) or ethanol (7).…”

Section: Discussionmentioning

confidence: 99%

“…In such cases, only permanent occlusion of all feeders and occlusion of the nidus would prevent the recurrence or residual rAVM. Superselective renal artery embolization commonly results in a small infarction of the nontarget renal parenchyma, which is usually not related with clinically significant reduction in function (5).…”

Section: Discussionmentioning

confidence: 99%

Congenital and Acquired Renal Arteriovenous Malformations: Curative Embolization with Onyx

et al. 2016

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Renal arteriovenous malformations are rare, as is their embolization with Onyx. Endovascular curative embolization of renal arteriovenous malformations with Onyx is a relatively new procedure. Herein we present two cases of congenital and one case of acquired renal arteriovenous malformation embolized with Onyx 18 and their good results in the follow-up period. We used detachable microcatheters, which may be more advantageous than the nondetachable ones, during the superselective embolizations. Onyx, as an efficient embolic material, can be commonly used for curative embolization of the renal arteriovenous malformations.

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Transcatheter Renal Artery Embolization: Clinical Applications and Techniques

Cited by 100 publications

References 45 publications

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

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

Embolização de artérias renais para o tratamento da hipertensão arterial não controlada

Congenital and Acquired Renal Arteriovenous Malformations: Curative Embolization with Onyx

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