Selective arterial embolization of angiomyolipoma leading to pulmonary hypertension.
OBJECTIVE
To report two cases of secondary pulmonary hypertension resulting from microsphere extravasation following selective arterial embolization of renal angiomyolipoma, its diagnosis, and management.


METHODS
We reviewed the cases of two patients at the University of California, San Francisco, treated with selective arterial embolization for management of their angiomyolipoma (AML) using Tris-Acryl Gelatin Microspheres.


RESULTS
Both patients were women, ages 51 and 77. Indications for treatment were the following: Patient 1 was treated for a large asymptomatic AML. Patient 2 was treated for a symptomatic, bleeding AML. Both patients developed progressive hypoxia following selective arterial embolization using Tris-Acryl Gelatin Microspheres. Each patient underwent a subsequent work up including a CT chest, echocardiogram, and chest x-ray. Both demonstrated significant pulmonary hypertension following their procedure and were discharged with supplemental oxygen.


CONCLUSIONS
Selective arterial embolization of AML with microsphere extravasation into the pulmonary vasculature can lead to pulmonary hypertension and hypoxemia.
Lee
Franklin
F
Department of Urology, University of California, San Francisco, California 94110, USA.
Aaronson
David S
DS
Blaschko
Sarah
S
Barbosa
Phil
P
Wu
Alex K
AK
Eisenberg
Michael
M
Erickson
Bradley A
BA
McAninch
Jack W
JW
D000368:Aged; D018207:Angiomyolipoma / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D007680:Kidney Neoplasms / Q000628:therapy*; D008875:Middle Aged