Long-term results of preventive embolization of renal angiomyolipomas: evaluation of predictive factors of volume...

Area of Science:

• Interventional Radiology
• Urologic Oncology
• Vascular Surgery

Background:

• Renal angiomyolipomas (AMLs) are benign tumors that can cause complications.
• Selective arterial embolization (SAE) is a minimally invasive treatment option for AMLs.
• Evaluating the efficacy and predictors of volume reduction after SAE is crucial for treatment optimization.

Purpose of the Study:

• To assess the effectiveness of SAE in reducing AML volume.
• To identify factors that predict significant volume decrease following SAE.
• To evaluate the safety of prophylactic SAE for renal AMLs.

Main Methods:

• Retrospective analysis of patients undergoing prophylactic SAE for renal AMLs over three years.
• Recorded volume changes post-SAE, and any hemorrhagic or surgical complications.
• Assessed initial tumor volume, fat content, density, embolic agent, number of AMLs, and tuberous sclerosis as potential predictors of volume reduction.

Main Results:

• 19 patients with 39 AMLs were analyzed; all SAE procedures were technically successful.
• Mean volume reduction was 72%, with no reported bleeding or need for nephrectomy post-SAE.
• Initial volume, percentage of fat content, and mean tumor density were significant predictors of volume decrease, with fat content being the strongest in multivariate analysis.

Conclusions:

• SAE is an effective treatment for devascularizing and reducing the volume of renal angiomyolipomas.
• The degree of volume reduction is influenced by the initial tumor volume and its tissue composition, particularly fat content.
• SAE offers a safe and effective approach with low radiation exposure for managing renal AMLs.