Elective and Emergency Renal Angiomyolipoma Embolization with Ethylene Vinyl Alcohol Copolymer: Feasibility and Initial Experience

Urbano, José; Paúl, Laura; Cabrera, Manuel López; Alonso‐Burgos, Alberto; Gómez, Daniella

doi:10.1016/j.jvir.2017.01.017

Cited by 26 publications

(29 citation statements)

References 24 publications

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“…Regarding the AML volume reduction, all kinds of embolic agents have shown similar results. Reported volume reduction rates are changing between 45.7% and 72% with alcohol, microparticles and EVOH copolymer (13,(20)(21)(22). In this study median volume decrease was 42% (12%-76%).…”

Section: Discussionmentioning

confidence: 55%

“…Patients may be presented with spontaneous retroperitoneal bleeding, hematuria and flank pain. AMLs that are larger than 4 cm, associated with tuberous sclerosis complex and AMLs with intratumoral aneurysms >5 mm are strongly associated with bleeding (7,(11)(12)(13). In this study 6 of the patients were presented with severe retroperitoneal hemorrhage and required an emergent procedure.…”

Section: Discussionmentioning

confidence: 80%

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Transarterial Embolization of Symptomatic Renal Angiomyolipomas

Salık¹

2019

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Amaç: Bu çalışmanın amacı semptomatik renal anjiyo myo lipomların (AML) tedavisinde transarteriyel embolizasyon tekniğinin etkinliğinin ve güvenilirliğinin araştırılmasıdır. Yöntemler: Bölümümüzde Eylül 2016 ve Aralık 2018 tarihleri arasında renal anjiyomyolipoma bağlı kanama semptomu ile refere edilen ve transarteriyel embolizasyon tekniği ile tedavi edilen hastaların tıbbi kayıtları incelenmiştir. Bütün besleyici arterler süperselektif olarak kateterize edildikten sonra partikül embolizasyonu uygulanmıştır. Mikropartikül ve koil embolizasyonu aktif ekstravazasyonu ve psödoanevrizması olan hastalarda uygulanmıştır. Bulgular: Çalışma süresinde 13 semptomatik hastada 14 AML embolize edilmiştir. 6 hastada akut retroperitoneal hemoraji mevcuttu ve bu hastaların tedavileri acil olarak uygulandı. Bütün hastalar semptomsuz olarak taburcu edildiler, bu nedenle klinik başarı oranı %100'dü. Majör komplikasyon ve ölüm gözlenmedi. Takip süresi sırasında ortanca hacim küçülmesi %42 (%12-%76) olarak hesaplandı. Sonuç: Semptomatik renal AML'lerin tedavisinde selektif transkateter arteriyel embolizasyon güvenilir, etkin ve uygulanabilir bir tedavi yöntemidir. Akut olarak rüptüre olmuş ve retroperitoneal kanamaya sebep olmuş AML'lerin tedavisinde mikropartikül ve koil embolizasyonu etkili biçimde kanamayı durdurabilir.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 80%

Transarterial Embolization of Symptomatic Renal Angiomyolipomas

Salık¹

2019

btd

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“…Loss of renal function consequently may be encountered. Several reports of embolization of RAML, however, reported no deterioration of renal function ( 23 , 24 , 132 ). Even with preexisting renal impairment, there was no significant change in renal function after embolization alone or associated with NSS ( 132 ).…”

Section: Risks Related To Managementmentioning

confidence: 92%

“…Embolization is associated with a high clinical success rate more than 90% ( 22 , 23 ). Successful control of a bleeding emergency was reported in 96–100% of patients ( 20 , 24 ). Bleeding occurs in both sporadic and TSC-associated lesions.…”

Section: Risk Of Bleedingmentioning

confidence: 99%

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

Seyam

Alkhudair

Kattan

et al. 2017

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Renal angiomyolipoma (RAML), though a rare benign tumor, may impose a significant morbidity or even mortality due to its unique characteristics and the complications subsequent to its treatment. The classic tumor variant is composed of smooth muscular, vascular, and fatty components. The most straightforward diagnosis is when the fat component is abundant and gives a characteristic appearance on different imaging studies. In fat-poor lesions, however, the diagnosis is difficult and presumed a renal cell carcinoma. Yet, some variants of RAML, though rare, express an aggressive behavior leading to metastasis and mortality. The challenge lies in the early detection of benign variants and identifying aggressive lesions for proper management. Another challenge is when the vascular tissue component predominates and poses a risk of hemorrhage that may extend to the retroperitoneum in a massive life-threatening condition. The predicament here is to identify the characteristics of tumors at risk of bleeding and provide a prophylactic treatment. According to the clinical presentation, different treatment modalities, prophylactic or therapeutic, are available that span the spectrum of observation, embolization, or surgery. Renal impairment may result from extensive tumor burden or as a complication of the management itself. Improvement of diagnostic techniques, super-selective embolization, nephron-sparing surgery, and late treatment with the mammalian target of rapamycin inhibitors have provided more effective and safe management strategies. In this review, we examine the evidence pertaining to the risks imposed by RAML to the patients and identify merits and hazards associated with different treatment modalities.

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“…Treatment of AMLs includes radical nephrectomy, nephron-sparing techniques (surgical intervention, percutaneous RF ablation, cryoablation, or microwave ablation), or percutaneous embolization, the latter is currently considered the treatment of choice [[4], [5]].…”

Section: Introductionmentioning

confidence: 99%

Use of a mixture of Lipiodol and Cyanoacrylate in percutaneous embolization treatment of symptomatic renal Angiomyolipomas: Our experience

Caloggero¹,

Catanzariti

Stagno

et al. 2019

Radiology Case Reports

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Purpose of this report is to describe safety and effectiveness of selective artery embolization in the treatment of bleeding angiomyolipomas (AMLs) of the kidney using a mixture of Lipiodol and Cyanoacrylate.Two patients with bleeding AMLs underwent to superselective embolization of the lesions using microcatheter and Lipiodol mixed with Cyanoacrylate in the ratio 3:1.Primary bleeding control rate was 100% with no major complications. Follow-up CT (mean time 18 months) demonstrated a significant reduction in size (about 50%) of the lesions.In conclusion, selective artery embolization with Lipiodol and Cyanoacrylate appear to be safe and effective in the treatment of bleeding AMLs.

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Elective and Emergency Renal Angiomyolipoma Embolization with Ethylene Vinyl Alcohol Copolymer: Feasibility and Initial Experience

Cited by 26 publications

References 24 publications

Transarterial Embolization of Symptomatic Renal Angiomyolipomas

Transarterial Embolization of Symptomatic Renal Angiomyolipomas

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

Use of a mixture of Lipiodol and Cyanoacrylate in percutaneous embolization treatment of symptomatic renal Angiomyolipomas: Our experience

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