Elective embolization for prevention of hemorrhage from renal angiomyolipomas

Among angiomyolipomas 4 cm or larger, 82%-94% are symptomatic and 50%-60% bleed spontaneously. Up to one-third of patients with these lesions present in shock. The effectiveness of elective embolization was evaluated in the prevention of bleeding from large (> or = 4 cm) angiomyolipomas while sparing the normal renal parenchyma.

Five cases from the authors' institution and 21 cases from the literature were reviewed retrospectively.

Embolization as the sole means of treatment was effective in 90% of patients over a follow-up period from 2 months to 7 years (mean, 21 months). There were no complications at the authors' institution. Serious procedure-related complications reported in the literature were limited to two cases of aneurysm rupture and two necrotic tumors requiring percutaneous drainage.

Embolization of renal angiomyolipomas is safe and well tolerated and may be of benefit in preventing life-threatening hemorrhage.