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Radiologic and clinical results of transarterial ethanol embolization for renal angiomyolipoma

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Abstract

Objective

We sought to determine the efficacy and safety of selective arterial embolization for renal angiomyolipoma (AML) using ethanol alone or ethanol with additional embolic materials and to analyze the factors influencing safety and efficacy.

Methods

One hundred nineteen AMLs treated with embolization were included retrospectively during a 15-year period. Technical, radiologic, and clinical success were recorded and risk factor analysis was performed. Complications on follow-up images, post-embolization syndrome (PES), major complications, and changes in renal function were also evaluated.

Results

Technical success was achieved in 106 of 119 tumors. Tumor size significantly decreased after treatment (reduction rate: 55%). Significant risk factors for tumor reduction included tumor enhancement on preprocedural CT and residual tumor staining. Radiologic success was achieved in 114 of 119 tumors (risk factor: residual tumor staining), and clinical success was achieved in 22 of 23 patients. Complications on follow-up images occurred in 40 of 119 tumors, and PES occurred in 53 of 104 patients. No major complications occurred. There were no cases of renal function impairment.

Conclusion

Selective transarterial embolization using ethanol alone or ethanol with additional embolic materials reduced AML size, alleviated symptoms, and can be performed safely without permanent impairment.

Key Points

• Percutaneous transarterial ethanol embolization reduces AML size and alleviates symptoms.

• Embolization can be performed safely without permanent impairment of renal function.

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Abbreviations

AML:

Angiomyolipoma

BUN:

Blood urea nitrogen

CT:

Computed tomography

DSA:

Digital subtraction angiography

MRI:

Magnetic resonance imaging

PES:

Post-embolization syndrome

TSC:

Tuberous sclerosis complex

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Kangwon National University Hospital, College of Medicine, Kangwon National University, 156 Baengnyeong-ro, Chuncheon, 24289, Republic of Korea

    Sangjoon Lee

  2. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Seoul, 06351, Republic of Korea

    Hong Suk Park, Dongho Hyun, Sung Ki Cho, Kwang Bo Park, Sung Wook Shin, Sung Wook Choo & Young Soo Do

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  1. Sangjoon Lee
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Correspondence to Hong Suk Park.

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The scientific guarantor of this publication is Hong Suk Park.

Conflict of interest

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.

Statistics and biometry

The “Statistics and Data Center at Samsung Medical Center” kindly provided statistical advice for this manuscript.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Lee, S., Park, H.S., Hyun, D. et al. Radiologic and clinical results of transarterial ethanol embolization for renal angiomyolipoma. Eur Radiol 31, 6568–6577 (2021). https://doi.org/10.1007/s00330-021-07831-y

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  • DOI: https://doi.org/10.1007/s00330-021-07831-y

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