Long-term follow-up of the treatment of renal angiomyolipomas after selective arterial embolization with alcohol
| Autor: | Yeh-Hong Tan, Shueh-En Lin, Richard Lo, Manish Taneja, Christopher Cheng, Bien Soo Tan, Kiang Hiong Tay, Christopher M. Chick |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Angiomyolipoma Urology medicine.medical_treatment Radiography Interventional Young Adult Internal medicine medicine.artery Antineoplastic Combined Chemotherapy Protocols medicine Humans Embolization Chemoembolization Therapeutic Renal artery Aged Retrospective Studies Ethanol business.industry Arterial Embolization Iodized Oil Retrospective cohort study Middle Aged medicine.disease Kidney Neoplasms Surgery Treatment Outcome Disease Progression Lipiodol Female Radiology Neoplasm Recurrence Local Complication business medicine.drug |
| Zdroj: | BJU International. 105:390-394 |
| ISSN: | 1464-410X 1464-4096 |
| DOI: | 10.1111/j.1464-410x.2009.08813.x |
| Popis: | Study Type – Therapy (case series) Level of Evidence 4 OBJECTIVE To present our institution’s experience of selective embolization of renal angiomyolipomas with alcohol and the long-term follow up data. PATIENTS AND METHODS This retrospective study included 34 patients treated between October 1997 and October 2007 (29 women and five men, mean age 44 years). Of these patients, nine had tuberous sclerosis, 14 were bilateral and 16 were multifocal. Indications for treatment were previous haemorrhage (14), size >4 cm (19) and increasing size over a short period (one). The largest treated lesion was 24.4 cm, and the mean (range) size was 11.9 (2.9–24.4) cm. All patients were treated by selective embolization using a mixture of alcohol and lipiodol. Three patients also had coiling of aneurysms and two patients had additional embolization with polyvinyl alcohol particles. The follow-up was both radiological and clinical, with recurrence defined as growth by >2 cm or symptoms requiring further treatment. RESULTS The technical success rate was 100%, with only one significant complication of non-target renal embolization, with self-limiting effects. Minor complications included 11 patients with post-embolization syndrome, all of which settled with conservative measures. The mean (range) combined radiological and clinical follow-up was 44.2 (12–116) months, with all patients having a follow-up of >1 year. Radiological success was achieved in 97%, with only one lesion growing by >2 cm. The combined clinical and radiological success rate was 85%, with two patients undergoing surgery, two having repeat embolization and one currently offered surgery due to a recent increase in size. CONCLUSION Our study provides long-term evidence that selective arterial embolization with alcohol is a safe and effective method for improving clinical symptoms (85%) and preventing tumour progression (97%) in patients with renal angiomyolipoma. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|