title: Urgent transcatheter arterial embolization for the treatment of ruptured renal angiomyolipoma with spontaneous hemorrhage.
abstract: Background The rich neovascularization of renal angiomyolipoma (AML) has a tendency for spontaneous rupture with subsequent hemorrhage. Nephrectomy or nephron-sparing surgery has rarely been used as a primary treatment in urgent situations. Purpose To evaluate the safety and long-term outcomes for patients treated by urgent transcatheter arterial embolization (TAE) for spontaneous ruptured renal AML with severe hemorrhage. Material and Methods A retrospective evaluation was performed of 25 renal AML cases with spontaneous hemorrhage confirmed by imaging. Polyvinyl alcohol (PVA) particles and coils of multiple sizes were used to embolize the spontaneous renal AML ruptures. Results The technical success rate of TAE was 96% (24/25). One week post-TAE, 1 patient with recurrent hemorrhage underwent emergency nephrectomy. Minor complications affected 16 patients with post-embolization syndrome; 15 patients resolved using conservative measures and one patient received nephrectomy post TAE 1 week later. All patients were followed up for 24-72 months (median, 50.2 months). Surgical treatment was avoided for 92% (23/25) of patients, and the re-embolization rate was 0% at 2 years post TAE. In the 23 patients without surgical treatment, the mean maximum diameter of renal AML was reduced from 12.4 ± 5.5 cm to 6.3 ± 2.5 cm and no hemorrhage occurred during follow-up. Conclusion Urgent TAE is a technically feasible and minimally invasive procedure for controlling severe hemorrhage and preservation of renal function following spontaneous ruptured renal AML.
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Xu-Hua
authors.initials: XH
authors.lastname: Duan
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Meng-Fan
authors.initials: MF
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Jian-Zhuang
authors.initials: JZ
authors.lastname: Ren
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Han
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Peng-Fei
authors.initials: PF
authors.lastname: Chen
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Zi-Ling
authors.initials: ZL
authors.lastname: Jia
mesh_terms: D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003422:Critical Care / Q000379:methods; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012421:Rupture; D016896:Treatment Outcome
keywords: Renal angiomyolipoma; renal function; spontaneous hemorrhage; transcatheter arterial embolization