Efficacy and Morbidity of Therapeutic Renal Embolization in the Spectrum of Urologic Disease

Jacobson, A. V. I. I.; Amukele, Samuel A.; Marcovich, Robert; Shapiro, Oleg; Shetty, Raviraj; Aldana, Joel Patrick A.; Lee, Benjamin R.; Smith, Arthur D.; Siegel, David

doi:10.1089/089277903767923164

Cited by 19 publications

(18 citation statements)

References 24 publications

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“…Também foi sugerida uma mistura de etanol com gelfoam ou com micropartículas, para aumentar a eficácia da embolização 10,11 . No entanto, poucas séries, com pacientes tratados por embolização da artéria renal podem ser vistas, e mesmo assim limitadas a um pequeno numero de pacientes [12][13][14][15][16] .…”

Section: Discussionunclassified

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Embolização pré operatória de tumores renais com microparticulas esféricas de tecnologia nacional. (Spherus®-First line Brasil)

Espinosa¹,

Miranda²,

Matias

et al. 2008

Rev. Col. Bras. Cir.

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Os autores relatam pela primeira vez utilização de uma nova partícula para embolização, constituída de um núcleo de acetato de polivinil revestido por polivinil-álcool, de forma esférica (Spherus®-First Line Brasil), como preparo pré-operatório em três pacientes portadores de neoplasia renal, na intenção de diminuir o tamanho do tumor e prevenir complicações hemorrágicas durante o ato operatório. Estas novas partículas foram projetadas e elaboradas nos laboratórios da COPPE/UFRJ. A embolização intra-arterial pré-operatória com estas novas partículas ocasionou acentuada isquemia em todo o tecido tumoral facilitando o procedimento cirúrgico.

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Section: Discussionunclassified

“…Quando tecnicamente possível, tumores de tamanho pequeno ou moderado são tratados por nefrectomia parcial. A remoção de grandes tumores estagio I, que frequentemente são hipervascularizados, é facilitada pela oclusão da artéria renal [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] .…”

Section: Discussionunclassified

Embolização pré operatória de tumores renais com microparticulas esféricas de tecnologia nacional. (Spherus®-First line Brasil)

Espinosa¹,

Miranda²,

Matias

et al. 2008

Rev. Col. Bras. Cir.

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“…The most familiar complication is the postembolization syndrome, characterized by symptoms of pain, fever and nausea, reported in up to 85% of cases; 1,13,14 the severity of these symptoms may be proportional to the size of the infarct. 14 Complications from surgery, including hemorrhage, urinary leak/fistula, tend to be more significant but are also rare. Overall, there is a 12% rate of complication for partial nephrectomy, including a 5% risk of urinary fistula.…”

Section: Stephen Faddegon Md; Alan So MD Frcscmentioning

confidence: 99%

Treatment of angiomyolipoma at a tertiary care centre: the decision between surgery and angioembolization

Faddegon

2013

CUAJ

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E138Cite as: Can Urol Assoc J 2011;5(6):E138-E141; http://dx.doi.org/10.5489/cuaj.10028. Epub 2011 Jan 13. AbstractBackground: Angiomyolipoma (AML) is a benign renal neoplasm. First-line therapy includes renal preserving surgery or angioembolization (RAE), both with good outcomes in isolated studies. However, there are no comparative randomized trials and no clinical guidelines to help clinicians decide between these treatment modalities. Our study examines the patterns of AML treatment at a tertiary care centre to evaluate how local urologists have been treating this disease. Methods: This is a retrospective study of all AMLs treated at the Vancouver General Hospital (Vancouver, BC, Canada) over the past 10 years with either RAE or surgical excision. Searches were performed of the radiology and pathology dictation systems, using the following keywords: AML, angiomyolipoma, angioembolization, embolization, surgery, partial nephrectomy and nephrectomy. Results: At our institution, more AMLs were treated by surgery than angioembolization (42 vs. 17 cases). Angioembolization was more often chosen for cases of multifocal AML (35% vs. 7%) and acute hemorrhage (50% vs. 14%). In the angioembolization cases, particles were the embolic agent of choice (used 40% of the time). Conclusions: Angioembolization allows rapid patient stabilization in cases of acute hemorrhage, and provides good renal preservation in cases of multifocal AML. It may also be preferred in large masses when partial nephrectomy is not feasible. Surgery should be performed in cases of diagnostic uncertainty or complex vascular anatomy not amenable to RAE. Prospective randomized studies are needed to compare RAE and surgery to better define their indications in sporadic AML. RésuméContexte : Un angiomyolipome (AML) est une tumeur bénigne du rein. Le traitement de première intention comprend une chirurgie de conservation rénale ou une angioembolisation rénale, qui ont toutes deux donné de bons résultats dans des études isolées. Cependant, aucun essai comparatif randomisé n'a été mené et il n'existe pas de lignes directrices pour aider les cliniciens à choisir entre ces modalités thérapeutiques. Notre étude a examiné les tendances dans le traitement de l'AML à un centre de soins tertiaires pour évaluer comment les urologues y traitent cette maladie.

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“…[43][44][45][46][47][48][49] However, there might be still some relevant indication for this procedure, such as the ablation of a graft after rejection, 50,51 and bilateral embolization of the remaining kidneys in transplant patients. 52,53 The decision has to be made according to the relative invasiveness of the procedure and the postoperative course.…”

Section: Perspectivesmentioning

confidence: 99%

Transarterial Nephrectomy: The Current Status of Experimental and Clinical Studies

Rassweiler

Prager

Haferkamp

et al. 2008

Journal of Endourology

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Capillary chemoembolization represents an effective concept for ablation of malignant renal tumors. It offers control of tumor growth in case of temporary inoperability as well as cessation of hematuria in a palliative situation. Because of the local ablative efficiency, it may still represent a minimally invasive option in advanced stages of renal carcinoma (i.e., in combination with immunochemotherapy or targeted therapy).

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Efficacy and Morbidity of Therapeutic Renal Embolization in the Spectrum of Urologic Disease

Abstract: Renal embolization is a highly effective and well-tolerated procedure in a variety of urologic conditions. The indications and material used did not have a significant effect on the outcome. Reducing parenchymal loss can significantly reduce morbidity.

Cited by 19 publications

References 24 publications

Embolização pré operatória de tumores renais com microparticulas esféricas de tecnologia nacional. (Spherus®-First line Brasil)

Embolização pré operatória de tumores renais com microparticulas esféricas de tecnologia nacional. (Spherus®-First line Brasil)

Treatment of angiomyolipoma at a tertiary care centre: the decision between surgery and angioembolization

Transarterial Nephrectomy: The Current Status of Experimental and Clinical Studies

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