[Role of embolization in renal angiomyolipomas].
OBJECTIVE
The purpose of this study is to present the role of embolization in the treatment of renal angiomyolipoma (AML) in cases of hemorrhage and to prevent bleeding.


METHODS
Over a period of 10 years, 35 AMLs in 34 patients, recruited in two medical centers, were treated with embolization: 16/35 AML were treated urgently to stop bleeding, and 19/35 AML had preventive embolization. Six patients were completely asymptomatic and 13 had a history of previous hematoma or flank pain. Catheterization was highly selective in all cases (coaxial microcatheter in 19 cases), and for embolization we used nonresorbable microparticles, coils, and alcohol.


RESULTS
When patients presented with acute bleeding, embolization was efficient in 80% of cases; another embolization was necessary in two cases, and surgery in two others. In six of these cases, surgery was planned and done at a later date. When treatment was preventive, one embolization was necessary in 17 cases, and two embolizations per case were necessary in the other two. Over a period of 18 months of follow-up, we observed a 28% decrease in tumor volume; four patients were treated by surgery at a later date.


CONCLUSIONS
Embolization is the technique of choice to treat a bleeding AML urgently. When preventive treatment is considered, in symptomatic or asymptomatic AML, embolization can be an alternative for surgery, but more data is needed to specify its proper place in the management of these tumors.
Dabbeche
C
C
Service de Radiologie, CHU Rangueil, 1 avenue J Poulhes, TSA 50032, 31059 Toulouse Cedex 9.
Chaker
M
M
Chemali
R
R
Perot
V
V
El Hajj
L
L
Ferriere
J M
JM
Ballanger
Ph
P
Chabbert
V
V
Cimpean
A
A
Otal
P
P
Huyghe
E
E
Grenier
N
N
Joffre
F
F
D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000150:complications*; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged