Tomita Kosuke, Matsumoto Tomohiro, Kamei Shunsuke, Yamamoto Shota, Suda Satoshi, Zakoji Hidenori, Hasebe Terumitsu
Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.
Department of Urology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.
CVIR Endovasc. 2020 Jan 8;3(1):3. doi: 10.1186/s42155-019-0095-8.
To evaluate the efficacy and safety of transcatheter arterial embolization for renal angiomyolipoma using a 1.8-French tip microballoon catheter and a mixture of ethanol and Lipiodol.
Seven consecutive patients with total of eight angiomyolipomas underwent this procedure between June 2014 and June 2017. A 1.8-French tip microballoon catheter was advanced to the feeding artery of the angiomyolipoma, and transcatheter arterial embolization was performed with a mixture of ethanol and Lipiodol under microballoon inflation. We retrospectively evaluated the characteristics of angiomyolipomas, technical success rate, clinical success rate, renal function, and adverse events. Technical success and clinical success were defined as complete embolization of all feeding arteries and reduction of tumor size, respectively.
The median size of the angiomyolipomas was 46 mm (range, 40-64 mm). Transcatheter arterial embolization was successful in all eight angiomyolipomas. The median volume of the mixture of ethanol and Lipiodol was 6.0 ml (range, 2.0-14 ml). The median ratio of ethanol to Lipiodol was 71% (range, 71-75%). All eight angiomyolipomas shrank with a median shrinkage rate of 34% in diameter (range, 9-63%) and 77% in volume (range, 48-94%). The median follow-up period was 13 months (range, 9-54 months). Clinical success was achieved in all cases. Serum creatinine concentrations and the pre- and post-procedural estimated glomerular filtration rates did not change notably, and there were no major complications.
Transcatheter arterial embolization for renal angiomyolipoma using a 1.8-French tip microballoon catheter with a mixture of ethanol and Lipiodol is effective and safe.
评估使用1.8法国规格尖端微球囊导管以及乙醇与碘油混合剂行经导管动脉栓塞术治疗肾血管平滑肌脂肪瘤的疗效和安全性。
2014年6月至2017年6月期间,连续7例共8个血管平滑肌脂肪瘤患者接受了该手术。将1.8法国规格尖端微球囊导管推进至血管平滑肌脂肪瘤的供血动脉,在微球囊充盈状态下用乙醇与碘油混合剂进行经导管动脉栓塞术。我们回顾性评估了血管平滑肌脂肪瘤的特征、技术成功率、临床成功率、肾功能及不良事件。技术成功定义为所有供血动脉完全栓塞,临床成功定义为肿瘤体积缩小。
血管平滑肌脂肪瘤的中位大小为46毫米(范围40 - 64毫米)。所有8个血管平滑肌脂肪瘤经导管动脉栓塞术均成功。乙醇与碘油混合剂的中位体积为6.0毫升(范围2.0 - 14毫升)。乙醇与碘油的中位比例为71%(范围71 - 75%)。所有8个血管平滑肌脂肪瘤均缩小,直径中位缩小率为34%(范围9 - 63%),体积中位缩小率为77%(范围48 - 94%)。中位随访期为13个月(范围9 - 54个月)。所有病例均取得临床成功。血清肌酐浓度以及术前和术后估算的肾小球滤过率无明显变化,且无重大并发症。
使用1.8法国规格尖端微球囊导管及乙醇与碘油混合剂行经导管动脉栓塞术治疗肾血管平滑肌脂肪瘤有效且安全。