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Long-term results of preventive embolization of renal angiomyolipomas: evaluation of predictive factors of volume decrease

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the efficacy of selective arterial embolization (SAE) of angiomyolipomas based on the percentage volume reduction after embolization and to identify predictive factors of volume decrease.

Methods

Patients receiving prophylactic SAE of renal angiomyolipomas were included retrospectively over 3 years. The volume change after SAE and haemorrhagic or surgical events were recorded. Initial tumour volume, percentage tumour fat content, mean tumour density, embolic agent used, number of angiomyolipomas and tuberous sclerosis disease were evaluated as predictive factors of volume decrease.

Results

A total of 19 patients with 39 angiomyolipomas were included with median follow-up of 28 months (interquartile range 21–37 months). All treatments were technically successful (92 % primary and 8 % secondary). No distal bleeding or any increase in size or surgical nephrectomy after SAE was recorded. Mean volume reduction was 72 % (±24 %). Volumes before SAE (R 2 = 0.276; p = 0.001), percentage fat content (R 2 = 0.612; p < 0.0001) and mean angiomyolipoma density (R 2 = 0.536; p < 0.0001) were identified as predictive factors of volume decrease. In multivariate regression, only percentage fat content influenced volume decreases.

Conclusions

SAE is an efficient treatment for angiomyolipoma devascularisation and volume reduction. A significant reduction of volume is modulated by the initial volume and tissue composition of the tumour.

Key Points

• Selective arterial embolization is effective for angiomyolipoma devascularisation and volume reduction

• Volume reduction depends of initial volume and tissue composition of the tumour

• Selective arterial embolization is a low radiation treatment

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Abbreviations

HU:

Hounsfield unit

PES:

post-embolization syndrome

SAE:

selective arterial embolization

TS:

tuberous sclerosis

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Acknowledgments

The authors thank Pippa McKelvie-Sebileau for medical editorial services. The scientific guarantor of this publication is Grenier Nicolas. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board because of the retrospective nature of the study. No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Diagnostic and Therapeutic Urology and Vascular Imaging, Centre Hospitalier Universitaire Pellegrin, Place Amélie-Raba-Léon, 33000, Bordeaux, France

    A. Hocquelet, F. Cornelis, Y. Le Bras, M. Meyer, E. Tricaud, A. S. Lasserre & N. Grenier

  2. Urology Service, Centre Hospitalier Universitaire Pellegrin, place Amélie-Raba-Léon, 33000, Bordeaux, France

    J. M. Ferrière & G. Robert

Authors
  1. A. Hocquelet
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  2. F. Cornelis
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  3. Y. Le Bras
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  4. M. Meyer
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  5. E. Tricaud
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  6. A. S. Lasserre
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  7. J. M. Ferrière
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  8. G. Robert
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  9. N. Grenier
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Correspondence to A. Hocquelet.

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Hocquelet, A., Cornelis, F., Le Bras, Y. et al. Long-term results of preventive embolization of renal angiomyolipomas: evaluation of predictive factors of volume decrease. Eur Radiol 24, 1785–1793 (2014). https://doi.org/10.1007/s00330-014-3244-4

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  • DOI: https://doi.org/10.1007/s00330-014-3244-4

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