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Embolization of Renal Angiomyolipomas: Short-Term and Long-Term Outcomes, Complications, and Tumor Shrinkage

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Abstract

This study retrospectively evaluated outcomes, complications, and tumor shrinkage in renal angiomyolipomas after transcatheter arterial embolization (TAE). All renal angiomyolipoma patients who underwent TAE between August 2000 and December 2008 and had short-term (≤6 months) or long-term (>6 months) follow-up images were evaluated. Complications and tumor relapse after TAE were reviewed. The sizes of embolized tumors were measured to calculate size reductions and reduction rates after TAE. Differences in tumor size, size reduction, and reduction rate between different time points (pre-TAE, short-term follow-up, and long-term follow-up) and groups (completely and incompletely embolized) were determined. Eleven renal angiomyolipoma patients who had undergone TAE were included. Seven (63.6%) patients had postembolization syndrome and one had abscess formation following TAE. Two patients had a tumor relapse (18.2%). The mean tumor size was 8.57 ± 2.66 cm on pre-TAE images. The mean size reduction was 3.1 cm (33.3%) and 3.8 cm (43.0%) at short-term and long-term follow-up. Tumor sizes differed significantly between pre-TAE and short-term (p = 0.004) or long-term images (p = 0.022) but not between short-term and long-term images (p = 0.059). Results stratified by the completeness of embolization indicate that only the short-term size reduction rate differed significantly (p = 0.025), while the long-term reduction rate and short- and long-term follow-up tumor size and size reduction were comparable between the two groups. In conclusion, selective TAE is effective for tumor shrinkage in most renal angiomyolipomas, with acceptable complication and relapse rates. Tumor shrinkage occurring within 6 months after TAE may reflect the long-term effect of TAE.

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References

  1. Bissler JJ, Kingswood JC (2004) Renal angiomyolipomata. Kidney Int 66:924–934

    Article  PubMed  Google Scholar 

  2. Nelson CP, Sanda MG (2002) Contemporary diagnosis and management of renal angiomyolipoma. J Urol 168:1315–1325

    Article  PubMed  Google Scholar 

  3. Bissler JJ, Racadio J, Donnelly LF et al (2002) Reduction of postembolization syndrome after ablation of renal angiomyolipoma. Am J Kidney Dis 39:966–971

    Article  PubMed  Google Scholar 

  4. Adler J, Greweldinger J, Litzky G (1984) “Macro” aneurysm in renal angiomyolipoma:two cases, with therapeutic embolization in one patient. Urol Radiol 6:201–203

    Article  CAS  PubMed  Google Scholar 

  5. Steiner MS, Goldman SM, Fishman EK et al (1993) The natural history of renal angiomyolipoma. J Urol 150:1782–1786

    CAS  PubMed  Google Scholar 

  6. Oesterling JE, Fishman EK, Goldman SM et al (1986) The management of renal angiomyolipoma. J Urol 135:1121–1124

    CAS  PubMed  Google Scholar 

  7. Ramon J, Rimon U, Garniek A, et al. (2008) Renal angiomyolipoma: long-term results following selective arterial embolization. Eur Urol. doi:10.1016/j.eururo.2008.04.025

  8. Lee W, Kim TS, Chung JW et al (1998) Renal angiomyolipoma: embolotherapy with a mixture of alcohol and iodized oil. J Vasc Interv Radiol 9:255–261

    Article  CAS  PubMed  Google Scholar 

  9. Han YM, Kim JK, Roh BS et al (1997) Renal angiomyolipoma: selective arterial embolization—effectiveness and changes in angiomyogenic components in long-term follow-up. Radiology 204:65–70

    CAS  PubMed  Google Scholar 

  10. Sacks D, McClenny TE, Cardella JF et al (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202

    PubMed  Google Scholar 

  11. Roach ES, Gomez MR, Northrup H (1998) Tuberous sclerosis complex consensus conference: revised clinical diagnostic criteria. J Child Neurol 13:624–628

    Article  CAS  PubMed  Google Scholar 

  12. Kaufman JA (2004) Vascular interventions. In: Kaufman JA, Lee MJ (eds) Vascular and interventional radiology: the requisites, 1st edn. Mosby, Philadelphia, pp 83–118

    Google Scholar 

  13. Lee SY, Hsu HH, Chen YC et al (2009) Evaluation of renal function of angiomyolipoma patients after selective transcatheter arterial embolization. Am J Med Sci 337(2):103–108

    Article  PubMed  Google Scholar 

  14. Dickinson M, Ruckle H, Beaghler M et al (1998) Renal angiomyolipoma: optimal treatment based on size and symptoms. Clin Nephrol 49:281–286

    CAS  PubMed  Google Scholar 

  15. Kessler OJ, Gillon G, Neuman M et al (1998) Management of renal angiomyolipoma: analysis of 15 cases. Eur Urol 33:572–575

    Article  CAS  PubMed  Google Scholar 

  16. Webb DW, Kabala J, Osborne JP (1994) A population study of renal disease in patients with tuberous sclerosis. Br J Urol 74:151–154

    Article  CAS  PubMed  Google Scholar 

  17. Rakowski SK, Winterkorn EB, Paul E et al (2006) Renal manifestations of tuberous sclerosis complex: incidence, prognosis, and predictive factors. Kidney Int 70:1777–1782

    Article  CAS  PubMed  Google Scholar 

  18. Hadley DA, Bryant LJ, Ruckle HC et al (2006) Conservative treatment of renal angiomyolipomas in patients with tuberous sclerosis. Clin Nephrol 65:22–27

    CAS  PubMed  Google Scholar 

  19. Ewalt DH, Diamond N, Rees C et al (2005) Long-term outcome of transcatheter embolization of renal angiomyolipomas due to tuberous sclerosis complex. J Urol 174:1764–1766

    Article  PubMed  Google Scholar 

  20. Harabayashi T, Shinohara N, Katano H et al (2004) Management of renal angiomyolipomas associated with tuberous sclerosis complex. J Urol 171:102–105

    Article  PubMed  Google Scholar 

  21. Rimon U, Duvdevani M, Garniek A et al (2006) Ethanol and polyvinyl alcohol mixture for transcatheter embolization of renal angiomyolipoma. Am J Roentgenol 187:762–768

    Article  Google Scholar 

  22. Glaiberman CB (2004) Tools of the trade for interventional radiologists. In: Waldman DL, Patel NC, Saad WEA (eds) Interventional radiology secret. Hanley & Belfus, Philadelphia, pp 11–20

    Google Scholar 

  23. Lee DE (2004) Endovascular management of trauma. In: Waldman DL, Patel NC, Saad WEA (eds) Interventional radiology secret. Hanley & Belfus, Philadelphia, pp 139–145

    Google Scholar 

  24. Williams JM, Racadio JM, Johnson ND et al (2006) Embolization of renal angiomyolipomata in patients with tuberous sclerosis complex. Am J Kidney Dis 47:95–102

    Article  PubMed  Google Scholar 

  25. Kaufman JA (2004) Fundamentals of angiography. In: Kaufman JA, Lee MJ (eds) Vascular and interventional radiology: the requisites, 1st edn. Mosby, Philadelphia, pp 31–66

    Google Scholar 

  26. Lenton J, Kessel D, Watkinson AF (2008) Embolization of renal angiomyolipoma: immediate complications and long-term outcomes. Clin Radiol 63(8):864–870

    Article  CAS  PubMed  Google Scholar 

  27. Kothary N, Soulen MC, Clark TW et al (2005) Renal angiomyolipoma: long-term results after arterial embolization. J Vasc Interv Radiol 16(1):45–50

    PubMed  Google Scholar 

  28. Yamakado K, Tanaka N, Nakagawa T et al (2002) Renal angiomyolipoma: relationships between tumor size, aneurysm formation, and rupture. Radiology 225:78–82

    Article  PubMed  Google Scholar 

  29. Takebayashi S, Horikawa A, Arai M, et al. (2008) Transarterial ethanol ablation for sporadic and non-hemorrhaging angiomyolipoma in the kidney. Eur J Radiol. doi:10.1016/j.ejrad.2008.06.017

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The editorial assistance of Ted Knoy is appreciated.

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Correspondence to Li-Jen Wang.

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Lee, SY., Hsu, HH., Chen, YC. et al. Embolization of Renal Angiomyolipomas: Short-Term and Long-Term Outcomes, Complications, and Tumor Shrinkage. Cardiovasc Intervent Radiol 32, 1171–1178 (2009). https://doi.org/10.1007/s00270-009-9637-0

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  • DOI: https://doi.org/10.1007/s00270-009-9637-0

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