Elective embolization for prevention of hemorrhage from renal angiomyolipomas.
OBJECTIVE
Among angiomyolipomas 4 cm or larger, 82%-94% are symptomatic and 50%-60% bleed spontaneously. Up to one-third of patients with these lesions present in shock. The effectiveness of elective embolization was evaluated in the prevention of bleeding from large (> or = 4 cm) angiomyolipomas while sparing the normal renal parenchyma.


METHODS
Five cases from the authors' institution and 21 cases from the literature were reviewed retrospectively.


RESULTS
Embolization as the sole means of treatment was effective in 90% of patients over a follow-up period from 2 months to 7 years (mean, 21 months). There were no complications at the authors' institution. Serious procedure-related complications reported in the literature were limited to two cases of aneurysm rupture and two necrotic tumors requiring percutaneous drainage.


CONCLUSIONS
Embolization of renal angiomyolipomas is safe and well tolerated and may be of benefit in preventing life-threatening hemorrhage.
Soulen
M C
MC
Division of Interventional Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Faykus
M H
MH
Shlansky-Goldberg
R D
RD
Wein
A J
AJ
Cope
C
C
D000328:Adult; D018207:Angiomyolipoma / Q000098:blood supply / Q000150:complications*; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies