Efficacy, Complications and Long-Term Outcomes of Selective Arterial Embolization of Symptomatic Giant Renal Angiomyolipoma

• Published in: Current urology 2012, Vol.5 (4), p.179-184
• Main Authors: El-Assmy, Ahmed, Abou-El-Ghar, Mohamed E., Mosbah, Ahmed, El-Refaie, Huda, El-Diasty, Tarek
• Format: Article
• Language: English
• Subjects: Original Paper
• ISSN: 1661-7649; 1661-7657
• DOI: 10.1159/000327475

Purpose: To assess efficacy, complications and long-term outcome of selective arterial embolization (SAE) for treatment of symptomatic giant angiomyolipoma larger than 10 cm. Materials and Methods: The surgical records of 9 patients with giant angiomyolipoma managed by SAE between 1990 and 2010 were reviewed. Results: The study included 4 men and 5 women, 5 of them (55.5%) had tuberous sclerosis complex. Indication for SAE was to stop severe hematuria in all patients. Among 9 patients, early complications occurred in 55.5% including post embolization syndrome in 1 patient, recurrent hematuria necessitating repeat embolization and nephrectomy in 3 and acute renal failure in 1 patient. During a mean follow-up of 2 years, 1 patient on hemodialysis was subjected to elective nephrectomy and 5 patients (55.5%) preserved their kidneys in whom radiology showed a decrease of size of the lesions by about 1/3 of its original size and all had a stable serum creatinine level. Conclusions: SAE of giant renal angiomyolipomas can be safely done to stop active bleeding in 2/3 of cases. Additional treatment may be necessary in 1/3 of patients and preservation of kidneys is amenable in 1/2 of cases.