The Role Of Transarterial Embolization In The Treatment Of Renal Tumors

Abstract

Background. Renal arterial embolization (RAE) is one of the adjunctive methods in the treatment of renal tumors. Embolization is performed in patients prior to nephrectomy, in patients with inoperable renal tumors as palliative treatment.Objectives. The purpose of the study was to present and to analyze our own experiences in the embolization of renal tumors. Material and Methods. A retrospective analysis of 33 patients treated using RAE between 2011 and 2013 was carried out. In 30 cases (91%), embolization was performed due to renal carcinoma and in 3 cases (9%) due to angiomyolipoma. In 11 patients intervention was performed as a palliative procedure because of advanced disease. Histoacrylic glue, polyvinyl alcohol, sponge pledgets and embolization coils were used for embolization. Results. In 20 patients (61%), selective RAE was performed, whereas superselective RAE was carried out in 13 patients (39%). The technical success rate of RAE was 100%. In one case the procedure was complicated by reflux of the histoacrylic glue into the common femoral artery with its embolization that required surgical embolectomy. We used histoacrylic glue in 26 embolizations (79%), in 19 procedures (58%) as the only embolization agent. Polyvinyl alcohol was used in 10 procedures (30%), gelatin sponge pledgets and absolute ethanol in 6 patients (18%). In 4 cases (12%), coils were implemented. In 22 patients (67%), one or more components of postembolization syndrome (PES) developed. In all 22 patients with PES (100%), severe lumbar pain was observed and administration of analgesics proved necessary. In 10 patients treated by palliative embolization, both a regression of macrohaematuria and an increase in hemoglobin level were observed. In 10 further patients, the creatinine level decreased following RAE. Conclusions. RAE is an effective and minimally-invasive intervention burdened with low risk of major complications. PES occurs in about two-third of patients. In the majority of patients after palliative embolization, haematuria decreases and the quality of life improves (Adv Clin Exp Med 2015, 24, 5, 837-843).

Nephrectomy Versus Embolization of Non-Functioning Renal Graft: A Systematic Review with a Proportional Meta-Analysis

“…Post-embolization syndrome is still frequent with this type of procedure, occurring in 68% of cases. Similar data have been reported in cases of renal artery embolization due to trauma or tumors [ 49 , 50 ]. Despite the frequency of the post-embolization syndrome, it is easily managed with analgesics and antipyretics.…”

Transarterial embolization for renal angiomyolipomas: A single centre experience in 79 patients

“… 9 While selective arterial embolization (SAE) for AMLs has gained popularity in recent years, few large studies are available with long-term follow-up data. 10 , 11 The objective of this retrospective study was to evaluate the long-term efficacy and safety of SAE in the treatment of AMLs in patients treated at our institution over a 7-year period (2007 to 2014).…”

Experiencia de embolización de la arteria renal previa a nefrectomía

“…La más común suele ser el síndrome de postembolización, caracterizado por dolor lumbar, fiebre y náuseas, el cual se ha reportado hasta en ⅔ de los pacientes sometidos a EAR. 20,21 En el presente estudio, la tasa general de complicaciones, con y sin EAR prenefrectomía, fue alrededor del 38% (n ¼ 27), sin la presencia de casos de mortalidad asociados a la realización de la embolización. Zargar y col, 8 por su parte, tras incluir 42 pacientes sometidos a EAR pre nefrectomía radical entre 2004 y 2011, de los cuales 7 de cada 10 tenían enfermedad avanzada (T3 y T4), documentaron alguna complicación operatoria en el 45,2%.…”