Interventional treatment of renal angiomyolipoma: immediate results and clinical and radiological follow-up of 4.5 years.
BACKGROUND
Renal angiomyolipoma is rare, but many of these patients may have an acute debut with severe bleeding. These patients need urgent treatment with interventional embolization as an attractive option.


OBJECTIVE
To investigate the technical and clinical effect of this treatment and to evaluate long-term clinical outcomes with clinical control and radiological imaging.


METHODS
Eight patients with angiomyolipoma were treated with embolization. Five patients were treated acutely. Five patients were followed-up for mean 4.5 years with clinical and radiological examinations.


RESULTS
The renal angiomyolipoma decreased significantly from mean 7.2 cm to 2.9 cm after embolization (p = 0.04). Cortical infarctions of about one-third of the circumference of the embolized kidneys could be detected on follow-up examinations, but all patients had normal total kidney function. The bleeding was primarily stopped in all patients, however, in one patient bleeding from a lumbar artery was supplementary embolized within 24 h. In another case the interventional procedure ended up in embolization of the whole kidney as it was impossible to embolize all the feeding arteries selectively. One patient had a nephrectomy one month after embolization because of infection and re-bleeding and one patient after 2.5 years because of tumor size >4 cm. The technical success was 7/8 (88%) and clinical success was 6/8 patients (75%).


CONCLUSIONS
Selective embolization of renal angiomyolipoma is a minimally invasive and safe procedure with few complications. It is a nephron sparing alternative to renal resection. The reduction in tumor size after embolization is significant and long-lasting.
Odense University Hospital, Odense C, Denmark.
Poul Erik
PE
Andersen
Odense University Hospital, Odense C, Denmark.
Mie Gaedt
MG
Thorlund
Odense University Hospital, Odense C, Denmark.
Gjertrud Egge
GE
Wennevik
Odense University Hospital, Odense C, Denmark.
Rune Lau
RL
Pedersen
Odense University Hospital, Odense C, Denmark.
Lars
L
Lund
Angiomyolipoma; embolization; interventional; kidney neoplasm; radiology; therapeutic