title: Palliative percutaneous kidney embolization with enbucrilate in patients with renal cell carcinoma: safety and symptom control.
abstract: BACKGROUND
  Primarily palliative renal embolization is a relatively rare procedure which is indicated in patients with unresectable kidney malignancies and in patients in poor general condition. The aim of this paper was to evaluate the role of primarily palliative transarterial renal embolization for the treatment of inoperable patients with renal cell carcinoma, assessing the indications, safety, and efficacy of this procedure.
  
  
  METHODS
  Seventy-three patients scheduled for palliative embolization between 1998 and 2005 were retrospectively analyzed regarding their medical history, the procedure report, and data from the early postoperative period.
  
  
  RESULTS
  Sixty-six of the 73 patients presented with renal cell carcinoma stage IV. The most common indication for embolization was hematuria (34%), followed by flank pain (32%), prophylaxis in stage IV (25%), lack of consent for surgery (7%), and poor general condition (3%). Embolizations were performed under local anesthesia with a mixture of enbucrilate and iodinated oil, with the use of additional embolizing materials in two cases. The procedure eliminated hematuria in 100% of cases and removed the loin pain completely in 72%. Migration of the embolizing material was observed in 10% of cases, and in 4% it resulted in symptomatic occlusion of the lower extremity distal arteries. Postembolic syndrome was noted in 92% of the patients
  
  
  CONCLUSIONS
  Percutaneous palliative embolization with enbucrilate is a safe and effective method of treating patients with unresectable renal cell carcinoma. The potential effect of the embolization on cancer progression and improvement of survival in these patients still requires prospective investigation.
authors.affiliation: Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum of Bydgoszcz, Bydgoszcz, Poland. serafin@cm.umk.pl
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Serafin
authors.forename: Maciej
authors.initials: M
authors.lastname: Karolkiewicz
authors.forename: Piotr
authors.initials: P
authors.lastname: Strześniewski
authors.forename: Władysław
authors.initials: W
authors.lastname: Lasek
authors.forename: Michał
authors.initials: M
authors.lastname: Bryczkowski
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Wolski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012189:Retrospective Studies
chemical_list: D004659:Enbucrilate