Treatment of Renal Adenocarcinoma by Embolic Occlusion of the Renal Circulation

Abstract

Summary An autologous muscle suspension mixed with contrast medium and injected via a catheter into the renal artery produces a partial thrombosis in the renal vessels with subsequent tissue neccosis. When applied to human cases of renal adenocarcinoma this technique produced a reduced vascularity and widespread necrosis of the tumorous kidney with an appreciable reuciton of its size. Troublesome bleeding ceased and tumours became more accessible to surgical removal. In addition, the findings in a limited number of patients with metastasising renal adenocarcinoma suggested that injection therapy followed by nephrectomy may have a fovourable effect on the further course of the discase. The technique was free from any serious complications and secondary hypertension was not observed.

The Role Of Transarterial Embolization In The Treatment Of Renal Tumors

“…The procedure was experimentally performed on dogs by Lalli et al [5]. Almgard et al, in 1973, performed embolization in a group of 19 human patients with advanced metastatic disease [6]. Next, in half of the patients, radical nephrectomy was performed and, according to the authors, the procedure was facilitated due to previous transarterial embolization.…”

Selective palliative transcatheter embolization of bony metastases from renal cell carcinoma

“…The technique of transcatheter embolization has been applied pre-operatively to both the primary tumor before nephrectomy [8,9] and metastatic bony lesions [10 Á13] to limit intra-operative blood loss. Selective transcatheter embolization of RCCa osseous metastases offers a reasonable and rational therapeutic approach for pain relief in this patient population.…”

Arterial Embolization for Radical Tumor Resection

“…Since preoperative arteriography was necessary for evaluation of the vascularity of thc tumor, little extra time or risk was involved in arterial embolization while the catheler was in place for this study. Arterial embolization preoperatively has been used in reducing the circulation to malignant tumors in urologic surgery (Almgard et al 1973). …”

“…Two contemporary measures, selective transarterial embolization (Almgard et al 1973) and controlled hypotensive anesthesia (Davis et al 1974), have been combined in an effort to reduce the risk of operative bleeding in a case of massive bone and muscle resection of a highly vascular carcinoma lesion in the proximal third of the femur. This approach may be helpful in such cases.…”