Selective arterial embolization in the management of symptomatic renal angiomyolipomas

Current management of renal angiomyolipomas (AMLs) include observation, transcatheter embolization and partial or total nephrectomy. Patients symptoms and size of the lesion are the determinants for the choice of the treatment. In general symptomatic or greater than 8 cm masses require intervention....

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Bibliographic Details
Published in:	European journal of radiology Vol. 32; no. 3; pp. 153 - 159
Main Authors:	Mourikis, Dimitrios, Chatziioannou, Achilles, Antoniou, Aristidis, Kehagias, Dimitrios, Gikas, Dimitrios, Vlahos, Lambros
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier Ireland Ltd 01-12-1999 Elsevier Science
Subjects:	Adolescent Adult Angiography Angiomyolipoma Angiomyolipoma - diagnostic imaging Angiomyolipoma - therapy Biological and medical sciences Blood vessels Embolization Embolization, Therapeutic - methods Humans Investigative techniques, diagnostic techniques (general aspects) Kidney Neoplasms - diagnostic imaging Kidney Neoplasms - therapy Kidneys Medical sciences Nephrology. Urinary tract diseases Radiodiagnosis. Nmr imagery. Nmr spectrometry Renal Retrospective Studies Surgery Tomography, X-Ray Computed Tuberous sclerosis Tumors of the urinary system Urinary system AMLs, angiomyolipomas Tuberous sclerosis Embolization TS, tuberous sclerosis Angiomyolipoma Renal Kidney disease Human Urinary system disease Radiodiagnosis Selection Instrumentation therapy Cardiovascular disease Artery Kidney Retrospective Angiolipoma Result Vascular disease Angioma Treatment Medical imagery Computerized axial tomography Benign neoplasm Technique
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Summary:	Current management of renal angiomyolipomas (AMLs) include observation, transcatheter embolization and partial or total nephrectomy. Patients symptoms and size of the lesion are the determinants for the choice of the treatment. In general symptomatic or greater than 8 cm masses require intervention. A retrospective study of five patients presented with symptomatic lesions and treated with selective transcatheter embolization, over a 3 year period was performed in our hospital. A total of eight embolizations were performed, all on an emergency basis due to retroperitoneal bleeding or significant hematuria. Surgical intervention was necessary in one case, due to massive rebleeding on the fourth post-procedural day. Two patients rebled within 6 months and 2 years respectively, and were managed successfully with additional embolization. The remaining two patients are still asymptomatic 26 and 18 months after the successful initial result. Experience with this procedure is reported on with emphasis to the clinical outcome. It is believed that selective arterial embolization should be the standard initial therapy for symptomatic renal AMLs.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0720-048X 1872-7727
DOI:	10.1016/S0720-048X(98)00179-X