Prophylactic selective arterial embolization for renal angiomyolipomas: efficacy and evaluation of predictive factors of significant shrinkage

Lin, Letao; Wang, Chengen; Pei, Renguang; Guan, Heng; Wang, Jian; Yang, Min; Tong, Xiaoqiang; Zou, Yinghua

doi:10.1007/s11255-018-1953-3

Cited by 15 publications

(16 citation statements)

References 19 publications

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“…Multiple renal vascular injuries can also contribute to severe bleeding [10]. In our study, 7 patients (20.0%) had repeated embolization, which was comparable to the rates in the reported literature [8,9]. The decrease in hemoglobin concentration is the most commonly used index for evaluating the severity of bleeding [19][20][21][22].…”

Section: Discussionsupporting

confidence: 80%

“…The rate of DOI: 10.1159/000508797 transfusion was reported between 1 and 55%, while the percentage of embolization varied from 0.6 to 1.5% in previous reports [2,3]. Although several studies had identified the risk factors of vascular complications after PCNL [4][5][6][7][8][9], the related studies are still few in number. Therefore, this study was to reveal the characteristic of severe renal arterial segment bleeding and to assess the outcome of SRAE.…”

Section: Introductionmentioning

confidence: 97%

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Outcome of Selective Renal Artery Embolization in Managing Severe Bleeding after Percutaneous Nephrolithotomy

Hong

Xiong

et al. 2020

Urol Int

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The aim of this study was to evaluate the characteristics of the renal arterial segment bleeding and assess the outcome of selective renal artery embolization (SRAE). Methods: Data on 35 patients in whom SRAE was performed after percutaneous nephrolithotomy (PCNL) from January 2005 to December 2015 in our institute were retrospectively analyzed. All patients had severe bleeding but failed to respond to conservative therapy. Results: Forty-four SRAEs were performed in 35 patients (36 kidney units) after PCNL. The findings of 44 renal arteriographies before embolization revealed bleeding in 44 renal artery branch segments. Upper artery segment bleeding in 0, upper and anterior segment bleeding in 3, lower and anterior artery segment bleeding in 6, lower artery segment bleeding in 9, posterior artery segment bleeding in 24, and negative finding in 2 patients. Renal arteriography revealed pseudoaneurysms in 20 (45.5%) patients, arteriovenous fistulas in 6 (13.6%) patients, renal artery branch laceration in 16 (36.4%) patients, and negative angiography finding in 2 (4.5%) patients. Acute bleeding in 7 patients (20.0%) and delayed bleeding in 28 patients (80.0%) were observed. The target vascular lesions were successfully treated by embolization in the first time in 28 cases. Six patients underwent 2 sessions and 1 had 3 sessions. New vascular lesions were the most common cause of failure of initial SEAE in our hospital. Abnormal renal function was observed in 5 patients, and they recovered to preoperative or normal level within 3 weeks. Conclusions: The posterior artery segment of the kidney is the most common bleeding site due to the choice of puncture site. Delayed bleeding (>24 h) was the most common type of bleeding. SRAE is an effective and safe method to treat the severe bleeding after PCNL.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 97%

Outcome of Selective Renal Artery Embolization in Managing Severe Bleeding after Percutaneous Nephrolithotomy

Hong

Xiong

et al. 2020

Urol Int

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“…The main reason for this finding may be the low angiomyogenic component of AMLs. 47 Lin et al. 47 showed that AMLs did not significantly decrease in size after embolization if the lesions had little blood supply.…”

Section: Discussionmentioning

confidence: 99%

Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis

Lin

Guan

et al. 2019

J Int Med Res

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Objective The present study aimed to evaluate renal function, complications, and changes in tumor size after transarterial embolization for patients with renal angiomyolipomas. Methods We performed a meta-analysis of transarterial embolization in patients with renal angiomyolipomas from January 1994 to April 2018. Endpoints of interest were the estimated glomerular filtration rate, serum creatinine levels, blood urea nitrogen levels, complications, and reduction of tumors. Results A total of 30 studies comprising 653 patients were included. A total of 32.0% of patients were treated by urgent transarterial embolization for spontaneous ruptured renal angiomyolipomas. Other patients sought to relieve symptoms or received embolism prophylactically. The estimated glomerular filtration rate showed no significant difference between before and after embolization. In 363 patients with data on complications, post-embolization syndrome occurred most frequently (54.0%). Only 16 (4.4%) patients had major complications. The diameter of sporadic angiomyolipomas was reduced by a mean of 2.09 cm (95% confidence interval [CI], 0.73–3.45 cm; I2 = 29.3%) and they were reduced in size by 30.0% (95% CI, 16.0%–44.0%; I2 = 27.9%). Conclusions Transarterial embolization of renal angiomyolipomas affects renal function preservation, with a low complication rate. Transarterial embolization is useful for sporadic and tuberous sclerosis complex-related angiomyolipomas.

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“…The longest heretofore reported follow-up of patients with renal AML was a mean of 7 years (range, 1.3-20.2). [8][9][10][11][12][13][14][15][16] Longitudinal data on long-term size reduction and retreatment rates are scarce. 8,17 We therefore represent 10-year follow-up of a relatively large cohort of patients who had undergone SAE for renal AML.…”

mentioning

confidence: 99%

Selective Arterial Embolization for Large or Symptomatic Renal Angiomyolipoma: 10 Years of Follow-up

Anis

Rimon

Ramon

et al. 2020

Urology

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Prophylactic selective arterial embolization for renal angiomyolipomas: efficacy and evaluation of predictive factors of significant shrinkage

Abstract: Prophylactic SAE is effective in reducing the size of renal AMLs and decreasing urine erythrocytes with preservation of renal function. Significant shrinkage of AMLs after SAE is modulated by the enhanced area and the background of TSC.

Cited by 15 publications

References 19 publications

Outcome of Selective Renal Artery Embolization in Managing Severe Bleeding after Percutaneous Nephrolithotomy

Outcome of Selective Renal Artery Embolization in Managing Severe Bleeding after Percutaneous Nephrolithotomy

Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis

Selective Arterial Embolization for Large or Symptomatic Renal Angiomyolipoma: 10 Years of Follow-up

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