title: The Role of Transarterial Embolization in the Treatment of Renal Tumors.
abstract: BACKGROUND
  Renal arterial embolization (RAE) is one of the adjunctive methods in the treatment of renal tumors. Embolization is performed in patients prior to nephrectomy, in patients with inoperable renal tumors as palliative treatment.
  
  
  OBJECTIVE
  The purpose of the study was to present and to analyze our own experiences in the embolization of renal tumors.
  
  
  METHODS
  A retrospective analysis of 33 patients treated using RAE between 2011 and 2013 was carried out. In 30 cases (91%), embolization was performed due to renal carcinoma and in 3 cases (9%) due to angiomyolipoma. In 11 patients intervention was performed as a palliative procedure because of advanced disease. Histoacrylic glue, polyvinyl alcohol, sponge pledgets and embolization coils were used for embolization.
  
  
  RESULTS
  In 20 patients (61%), selective RAE was performed, whereas superselective RAE was carried out in 13 patients (39%). The technical success rate of RAE was 100%. In one case the procedure was complicated by reflux of the histoacrylic glue into the common femoral artery with its embolization that required surgical embolectomy. We used histoacrylic glue in 26 embolizations (79%), in 19 procedures (58%) as the only embolization agent. Polyvinyl alcohol was used in 10 procedures (30%), gelatin sponge pledgets and absolute ethanol in 6 patients (18%). In 4 cases (12%), coils were implemented. In 22 patients (67%), one or more components of postembolization syndrome (PES) developed. In all 22 patients with PES (100%), severe lumbar pain was observed and administration of analgesics proved necessary. In 10 patients treated by palliative embolization, both a regression of macrohaematuria and an increase in hemoglobin level were observed. In 10 further patients, the creatinine level decreased following RAE.
  
  
  CONCLUSIONS
  RAE is an effective and minimally-invasive intervention burdened with low risk of major complications. PES occurs in about two-third of patients. In the majority of patients after palliative embolization, haematuria decreases and the quality of life improves.
authors.affiliation: Department of General and Interventional Radiology and Neuroradiology, Chair of Radiology, Wroclaw Medical University, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Guziński
authors.affiliation: Department of General and Interventional Radiology and Neuroradiology, Chair of Radiology, Wroclaw Medical University, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kurcz
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Tupikowski
authors.affiliation: Department of General and Interventional Radiology and Neuroradiology, Chair of Radiology, Wroclaw Medical University, Poland.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Antosz
authors.affiliation: Department of General and Interventional Radiology and Neuroradiology, Chair of Radiology, Wroclaw Medical University, Poland.
authors.forename: Paulina
authors.initials: P
authors.lastname: Słowik
authors.affiliation: Department of General and Interventional Radiology and Neuroradiology, Chair of Radiology, Wroclaw Medical University, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Garcarek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply* / Q000628:therapy*; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D010166:Palliative Care / Q000379:methods*; D057234:Preoperative Period; D011788:Quality of Life; D012077:Renal Artery; D012189:Retrospective Studies; D016896:Treatment Outcome