title: Long-term results of preventive embolization of renal angiomyolipomas: evaluation of predictive factors of volume decrease.
abstract: OBJECTIVE
  To evaluate the efficacy of selective arterial embolization (SAE) of angiomyolipomas based on the percentage volume reduction after embolization and to identify predictive factors of volume decrease.
  
  
  METHODS
  Patients receiving prophylactic SAE of renal angiomyolipomas were included retrospectively over 3 years. The volume change after SAE and haemorrhagic or surgical events were recorded. Initial tumour volume, percentage tumour fat content, mean tumour density, embolic agent used, number of angiomyolipomas and tuberous sclerosis disease were evaluated as predictive factors of volume decrease.
  
  
  RESULTS
  A total of 19 patients with 39 angiomyolipomas were included with median follow-up of 28 months (interquartile range 21-37 months). All treatments were technically successful (92% primary and 8% secondary). No distal bleeding or any increase in size or surgical nephrectomy after SAE was recorded. Mean volume reduction was 72% (±24%). Volumes before SAE (R(2) = 0.276; p = 0.001), percentage fat content (R(2) = 0.612; p < 0.0001) and mean angiomyolipoma density (R(2) = 0.536; p < 0.0001) were identified as predictive factors of volume decrease. In multivariate regression, only percentage fat content influenced volume decreases.
  
  
  CONCLUSIONS
  SAE is an efficient treatment for angiomyolipoma devascularisation and volume reduction. A significant reduction of volume is modulated by the initial volume and tissue composition of the tumour.
  
  
  CONCLUSIONS
  • Selective arterial embolization is effective for angiomyolipoma devascularisation and volume reduction • Volume reduction depends of initial volume and tissue composition of the tumour • Selective arterial embolization is a low radiation treatment.
authors.affiliation: Diagnostic and Therapeutic Urology and Vascular Imaging, Centre Hospitalier Universitaire Pellegrin, Place Amélie-Raba-Léon, 33000, Bordeaux, France, nonobdx@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Hocquelet
authors.forename: F
authors.initials: F
authors.lastname: Cornelis
authors.forename: Y
authors.initials: Y
authors.lastname: Le Bras
authors.forename: M
authors.initials: M
authors.lastname: Meyer
authors.forename: E
authors.initials: E
authors.lastname: Tricaud
authors.forename: A S
authors.initials: AS
authors.lastname: Lasserre
authors.forename: J M
authors.initials: JM
authors.lastname: Ferrière
authors.forename: G
authors.initials: G
authors.lastname: Robert
authors.forename: N
authors.initials: N
authors.lastname: Grenier
mesh_terms: D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000175:diagnosis / Q000628:therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D000970:Antineoplastic Agents