Publication: Selective Arterial Embolization of Renal Angiomyolipoma: Efficacy, Tumor Volume Reduction, and Complications
Issued Date
2021-01-01
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22288082
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2-s2.0-85106630092
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Mahidol University
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SCOPUS
Bibliographic Citation
Siriraj Medical Journal. Vol.73, No.5 (2021), 337-343
Suggested Citation
Walailak Chaiyasoot, Jirawadee Yodying, Thanita Limsiri Selective Arterial Embolization of Renal Angiomyolipoma: Efficacy, Tumor Volume Reduction, and Complications. Siriraj Medical Journal. Vol.73, No.5 (2021), 337-343. doi:10.33192/Smj.2021.44 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78726
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Title
Selective Arterial Embolization of Renal Angiomyolipoma: Efficacy, Tumor Volume Reduction, and Complications
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Abstract
Objective: To evaluate the efficacy and complications of selective arterial embolization in renal angiomyolipomaand to identify predictive factors for tumor rupture.Materials and Methods: Twenty-one patients with 25 renal angiomyolipoma (AML) underwent selective arterialembolization (SAE) between January 2008 and June 2019, 15 lesions involving prophylaxis embolization of atumor >4 cm diameter and 10 involving embolization for a ruptured tumor. Multidetector computed tomography(MDCT) was performed pre- and post-SAE, using the 2D tumor diameter measurement in the ruptured AMLs.Three-dimensional volumetry and density histogram were performed for determining the total tumor volume, fat,and angiomyogenic component reduction in the unruptured AMLs. The predictive factors for tumor rupture, thetreatment outcome and complications were analyzed.Results: The clinical success rate was 84% (21/25 lesions) and the technical success rate was 96% (24/25 lesions). The3D volume post-SAE within 1-3 months showed a greater decrement of the enhanced angiomyogenic componentthan the fat component, with median percentages of -62.2% and -18.4%, respectively (p-value = 0.333). Minorcomplications were post-embolization syndrome (5 lesions, 20%) and minimal renal infarction (4 lesions, 16%).Renal abscesses were the major complications (3 lesions, 12%). A factor associated with tumor rupture was thepresence of an intra-tumoral aneurysm (p-value < 0.05).Conclusion: SAE is an effective treatment for renal AML with a high technical and clinical success rate andlimited complications. Three-dimensional volumetry and density histogram analysis might be better tools thantwo-dimensional CT to evaluate post-SAE response. The presence of an intra-tumoral aneurysm is a significantpredictive factor associated with tumor rupture.