Renal Angiomyolipoma: Mid- to Long-Term Results Following Embolization with Onyx

Thulasidasan, Narayanan; Sriskandakumar, Srividhiya; Ilyas, Shahzad; Sabharwal, Tarun

doi:10.1007/s00270-016-1432-0

Cited by 22 publications

(19 citation statements)

References 17 publications

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“…Among the 30 studies, 18 studies scored 11 points 11–28 in the Agency for Healthcare Research and Quality Cross-Sectional/Prevalence Study Quality checklists, six studies scored 10 points, 29–34 three studies scored 9 points, 35–37 and the other three studies scored 8 points. 38–40…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

“…PES was reported in 16 (363 patients) studies, 11–14,17,21,22,28–32,36,37,40 in which researchers adopted different approaches to PES. As a result, the rate of PES was 54.0% (95.0% CI, 36.6%–70.4%; I 2 = 91.0%; p < 0.001) (Figure 4), with a significant difference between studies.…”

Section: Resultsmentioning

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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“…Each of these materials has its own advantages and drawbacks. Among liquid agents, Onyx ® (Medtronic, Dublin, Ireland), in which the non-adhesive glue is ethylene vinyl-alcohol copolymer (EVOH) and the radio-opaque agent tantalum powder, has been used in several studies for SAE of rAMLs [ 13 , 14 ]. On the other hand, N-butyl 2-cyanoacrylate (NBCA) is an adhesive liquid embolic agent whose properties differ from those of Onyx ® .…”

Section: Introductionmentioning

confidence: 99%

Selective Arterial Embolization of Renal Angiomyolipomas with a N-Butyl Cyanoacrylate-Lipiodol Mixture: Efficacy, Safety, Short- and Mid-Term Outcomes

Prigent¹,

Guillen²,

Comby³

et al. 2021

JCM

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Selective arterial embolization (SAE) for renal angiomyolipoma (rAML) is effective to treat or prevent bleeding. We report our experience using a cyanoacrylate–Lipiodol mixture. We performed a single-center retrospective review of all rAMLs embolized with cyanoacrylate glue between July 2014 and June 2020. Demographics, tuberous sclerosis complex (TSC) status, clinical presentation, angiography features, and follow-up data were recorded. Pre- and post-procedure rAML sizes and volumes were estimated from computed tomography (CT) or magnetic resonance imaging (MRI) studies. Kidney function was assessed before and after the procedure. We identified 24 patients (22 females and 2 males, mean age 51 years) treated for 27 AMLs, either prophylactically (n = 20) or as an emergency (n = 4). Technical success was achieved for 25/27 AMLs; two patients, each with a single AML, required nephrectomy and repeated embolization, respectively. Major complications occurred in three patients and minor complications such as postembolization syndrome in 15 patients. AML volume reduction after embolization was 55.1% after a mean follow-up of 15 months (range, 1–72 months). Factors associated with greater volume reduction were a smaller percentage of fat (p = 0.001), larger initial rAML volume (p = 0.014), and longer follow-up (p = 0.0001). The mean creatinine level did not change after SAE. Embolization of rAMLs with a mixture of cyanoacrylate and Lipiodol is feasible, safe, and effective in significantly decreasing tumor volume.

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“…In the literature, different embolization agents such as microparticles, ethylene vinyl alcohol (EVOH) copolymer, absolute alcohol and coils have been reported as effective in treatment of AMLs. For complete embolization of distal vascular bed microparticles, ethanol and EVOH copolymers have been used (16)(17)(18)(19). Intralesional aneurysms and pseudoaneurysms have been shown to be strongly related with tumor rupture and acute hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Transarterial Embolization of Symptomatic Renal Angiomyolipomas

Salık¹

2019

btd

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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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Renal Angiomyolipoma: Mid- to Long-Term Results Following Embolization with Onyx

Abstract: Onyx embolization of renal AMLs is effective in the medium to long term, with theoretical benefits in safety and durability of result.

Cited by 22 publications

References 17 publications

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

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

Selective Arterial Embolization of Renal Angiomyolipomas with a N-Butyl Cyanoacrylate-Lipiodol Mixture: Efficacy, Safety, Short- and Mid-Term Outcomes

Transarterial Embolization of Symptomatic Renal Angiomyolipomas

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