Transarterial Embolization of Angiomyolipoma: A Systematic Review

Murray, Timothy; Doyle, Frank; Lee, Michael

doi:10.1016/j.juro.2015.04.081

Cited by 89 publications

(109 citation statements)

References 31 publications

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“…Moreover, elective embolization is also reserved for patients with large growing AML to stop hemorrhage and preserve kidney function (39,40). More recently, this procedure was used for asymptomatic (nonhemorrhagic) large AMLs with serial growth as well.…”

Section: Treatmentmentioning

confidence: 99%

“…Sooriakumaran et al observed some procedure-related complications including postembolization syndrome, abscess formation, nonfunctioning kidney, and refractory hypertension derived from segmental renal infarct (10). Distinct embolic materials have been applied for AMLs such as polyvinyl alcohol, particles, gelfoam, alcohol or N-butyl cyanoacrylate, liquid ethylene vinyl alcohol copolymer, and coils (40). In this procedure, to decrease the risk of AML regrowth by new collateralization, it is recommended to embolize both the distal tumoral capillary bed and the proximal feeding vessels.…”

Section: Treatmentmentioning

confidence: 99%

“…In this procedure, to decrease the risk of AML regrowth by new collateralization, it is recommended to embolize both the distal tumoral capillary bed and the proximal feeding vessels. Some studies have reported a recurrence rate of 10% to 42.9% (39)(40)(41). The statistics significantly increase in AML patients associated with TSC (41).…”

Section: Treatmentmentioning

confidence: 99%

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Recent Strategies for the Management of Renal Angiomyolipoma: A Review of Diagnostic and Therapeutic Approaches

et al. 2017

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Recent prophylactic treatment options and diagnostic tools show a suboptimal improvement in patients with renal angiomyolipoma (AML). This study was an attempt to review management strategies applied before invasive options. An extensive research on medical databases such as PubMed and Scopus was performed from 1999 to 2016 using the following keywords: 'kidney', 'renal', and 'angiomyolipoma'. All related studies on patients treating with conservative or minimally-invasive procedures were included. However, reports on surgical treatments were excluded. Treatment strategies have been selected based on outcomes resulting from computed tomography (CT) and magnetic resonance (MR) imaging. Fat content and tumor size are the most common used indications for AMLs. Unenhanced CT and chemical shift imaging provide good evidence in case of fat-poor AMLs. Chemical analysis and percutaneous biopsy are recommended in case of a diagnostic challenge. A tumor size of 6 cm or larger in diameter might necessitate invasive treatment, while AMLs patients with tumors around 4 cm may require prophylactic treatment. Of all treatment options, embolization indicated a high risk of reintervention. Moreover, everolimus and sirolimus as 2 inhibitors of mammalian target of rapamycin (mTOR) have been evaluated in clinical trials and demonstrated promising outcomes. In conclusion, advances in imaging techniques along with mTOR inhibitors and embolic materials potentiate functional outcomes in AMLs.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Recent Strategies for the Management of Renal Angiomyolipoma: A Review of Diagnostic and Therapeutic Approaches

et al. 2017

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“…Besides, 20.9% of patients underwent re-embolization due to angiomyolipoma revascularization, unchanged or increasing size of tumor, refractory, or recurring symptoms, etc. [24] . Meanwhile, with the advancements made in the field of surgical equipment and skills, partial nephrectomy, advocated as an alternative treatment for RAMLs [3,12] , can excise the lesion and maximally save nephrons as well.…”

Section: Discussionmentioning

confidence: 99%

Super-Selective Artery Embolization before Laparoscopic Partial Nephrectomy in Treating Renal Angiomyolipoma

Qin

Wang²,

Li³

et al. 2017

Urol Int

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Introduction: To investigate the feasibility and efficiency of super-selective artery embolization (SAE) before laparoscopic partial nephrectomy (LPN) in treating renal angiomyolipoma (RAML). Materials and Methods: A retrospective analysis was conducted on 36 consecutive patients who underwent SAE before LPN (group A, n = 16) or LPN directly (group B, n = 20) from June 2010 to March 2016. Intraoperative blood loss, blood transfusion, operation time, warm ischemia time (WIT), and prognosis were compared between groups. Results: SAE before LPN decreased operating time, intraoperative blood loss and WIT (p < 0.05), and improved postoperative renal function (p < 0.001). Complications in group B included intraoperative blood loss of 4 patients and postoperative hematuria of 2 patients who recovered a few days later. No complications were observed in group A. In the follow-up of 3 months, a patient in group B formatted retroperitoneal hematoma without any symptoms and received expectant treatment. Conclusions: The application of SAE before LPN can decrease the difficulty of the surgery, the complications, and the risk of rebleeding and RAMLs recurrence.

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“…[5] A systemic review of 524 cases showed that TAE of angiomyolipomas demonstrates low rates of mortality but with serious complications; with the most common complications being the need for revascularization in up to 30% of the cases, and recurring or refractory symptoms in 16.7%. [6] There have not been large studies published in regards to nephron sparing surgery in the approach to angiomyolipoma; however case series and case reports have reported low complication rates of up to 12% with low local recurrence rates. [7] Specifically with regards to giant AML, there has been another case report which was also managed through a partial nephrectomy without prior embolization, and showed good recovery with a short hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Successful management of a giant angiomyolipoma with partial nephrectomy

Lim

D.T

Yee

2015

CSS

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Renal angiomyolipoma (AML) is largely defined as a benign tumor with 3 components: adipose tissue, abnormally thick-walled blood vessels and smooth muscle. Varying sizes of AML has been reported in the literature, with the general consensus that a size greater than 10 cm can be termed a giant AML and are associated with increased complications. This report discusses a case of giant AML with a diameter of up to 24 cm that underwent a successful partial nephrectomy without prior embolization.

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Transarterial Embolization of Angiomyolipoma: A Systematic Review

Cited by 89 publications

References 31 publications

Recent Strategies for the Management of Renal Angiomyolipoma: A Review of Diagnostic and Therapeutic Approaches

Recent Strategies for the Management of Renal Angiomyolipoma: A Review of Diagnostic and Therapeutic Approaches

Super-Selective Artery Embolization before Laparoscopic Partial Nephrectomy in Treating Renal Angiomyolipoma

Successful management of a giant angiomyolipoma with partial nephrectomy

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