Lin Letao, Li Xinfei, Guan Haitao, Wang Jian, Tong Xiaoqiang, Yang Min, Zou Yinghua
Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, P.R. China.
J Int Med Res. 2019 Apr;47(4):1417-1428. doi: 10.1177/0300060519834447. Epub 2019 Mar 21.
The present study aimed to evaluate renal function, complications, and changes in tumor size after transarterial embolization for patients with renal angiomyolipomas.
We performed a meta-analysis of transarterial embolization in patients with renal angiomyolipomas from January 1994 to April 2018. Endpoints of interest were the estimated glomerular filtration rate, serum creatinine levels, blood urea nitrogen levels, complications, and reduction of tumors.
A total of 30 studies comprising 653 patients were included. A total of 32.0% of patients were treated by urgent transarterial embolization for spontaneous ruptured renal angiomyolipomas. Other patients sought to relieve symptoms or received embolism prophylactically. The estimated glomerular filtration rate showed no significant difference between before and after embolization. In 363 patients with data on complications, post-embolization syndrome occurred most frequently (54.0%). Only 16 (4.4%) patients had major complications. The diameter of sporadic angiomyolipomas was reduced by a mean of 2.09 cm (95% confidence interval [CI], 0.73-3.45 cm; I = 29.3%) and they were reduced in size by 30.0% (95% CI, 16.0%-44.0%; I = 27.9%).
Transarterial embolization of renal angiomyolipomas affects renal function preservation, with a low complication rate. Transarterial embolization is useful for sporadic and tuberous sclerosis complex-related angiomyolipomas.
本研究旨在评估肾血管平滑肌脂肪瘤患者经动脉栓塞术后的肾功能、并发症及肿瘤大小变化。
我们对1994年1月至2018年4月期间肾血管平滑肌脂肪瘤患者的经动脉栓塞术进行了一项荟萃分析。感兴趣的终点指标为估计肾小球滤过率、血清肌酐水平、血尿素氮水平、并发症及肿瘤缩小情况。
共纳入30项研究,包含653例患者。共有32.0%的患者因自发性破裂的肾血管平滑肌脂肪瘤接受了紧急经动脉栓塞术。其他患者旨在缓解症状或接受预防性栓塞。栓塞前后估计肾小球滤过率无显著差异。在363例有并发症数据的患者中,栓塞后综合征最为常见(54.0%)。仅有16例(4.4%)患者出现严重并发症。散发性血管平滑肌脂肪瘤的直径平均缩小2.09 cm(95%置信区间[CI],0.73 - 3.45 cm;I² = 29.3%),大小缩小30.0%(95% CI,16.0% - 44.0%;I² = 27.9%)。
肾血管平滑肌脂肪瘤经动脉栓塞术有助于保留肾功能,并发症发生率低。经动脉栓塞术对散发性及与结节性硬化症相关的血管平滑肌脂肪瘤有效。