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

A Comparison of Laparoscopic Enucleation with Preoperative Selective Arterial Embolization (SAE) and Non-SAE for Renal Angiomyolipoma: A Meta-Analysis

“…Sun et al conducted a real-world study to compare embolization and nephrectomy for renal RAMLs associated with TSC, and embolization was effective, with a reduction in gross hematuria (− 27.7%), retroperitoneal hemorrhage (− 8.4%), and abdominal mass (− 6.9%) [17]. Anis et al assessed long-term outcomes after SAE as rst-line treatment for large or symptomatic AML and found SAE was a safe procedure that was associated with freedom from surgery and CKD of 94% and 92.4%, respectively at 10 years post-procedure [3]. However, as reported by most studies, SAE's role in reducing tumor volume is limited.…”

“…However, as reported by most studies, SAE's role in reducing tumor volume is limited. Most RAMLs have shrunk by only 20%-30% after successful embolization [18][19][20], and showed a high re-embolization rate (41.1%) [3]. Embolization is effective in controlling severe spontaneous hemorrhage in the acute phase, but be of limited value in treating large RAMLs in the long run [21].…”

“…RAML can be sporadic or occur with tuberous sclerosis complex (TSC) or lung lymphangioleiomyomatosis (LAM) [2]. The prevalence of AML is much more common than previously thought, and it is now estimated as being around 13 per 10,000 in the general population, with a female to male ratio of 2-4:1 [3]. The insidious growth of these tumors predisposes patients to some serious complications, such as retroperitoneal hemorrhage due to rupture, which can be life-threatening [2,4].…”

Endovascular approaches in pediatric interventional oncology

“…Renal angiomyolipomas (AML) at a younger age, is aggressive and typically represents a component of tuberous-sclerosis-complex (Anis et al 2020). The tumor comprising of fat and smooth muscle elements have a more than 50% risk of rupture and hemorrhage when greater than 4 cm in diameter (Rimon et al 2006).…”

“…Transcatheter renal artery embolization can be performed for hemorrhage from angiomyolipomas eliminating the need for blood transfusion and surgery in technically successful cases and, decrease tumor size in non-hemorrhagic AML (Hamlin et al 1997;Dabbeche et al 2006;Bardin et al 2017;El Rafei et al 2015). Transarterial embolization can be considered a safe primary option for symptomatic or larger AML (Anis et al 2020). In patients with hematuria from renal tumors, such as, malignant rhaboid tumor, embolization can be performed to stop bleeding and facilitate chemotherapy (Sharma et al 2013).…”