Department of Radiology, Hacettepe University Hospital, İstanbul, Turkey.
Department of Urolog, Hacettepe University Hospital, İstanbul, Turkey.
Diagn Interv Radiol. 2022 Nov;28(6):597-602. doi: 10.5152/dir.2022.201044.
PURPOSE This study evaluated single center results of endovascular treatment in renal angiomyolipoma (AML) to determine whether there is clinical relevance of adding proximal coil embolization to distal particle embolization in terms of safety, efficacy and retreatment rates. METHODS A retrospective analysis was performed to evaluate patients undergoing transarterial embolization for renal AMLs from January 2007 to October 2020. Parameters regarding patient and tumor characteristics, embolization technique, treatment outcome and complications were recorded. Patients were divided into two groups as A (only particle group) and B (particle + coil group) based on the type of embolic agent used for treatment. Comparative analysis was performed between the two groups in terms of tumor size reduction, retreatment and complication rates. RESULT Forty-two patients (37 (88.1%) female, 5 (11.9%) male) harboring 48 AMLs were included in the study. The mean age was 43.46 (range 20 to 78). The technical success rate was 95.8% (46 of 48 procedures). The mean size reduction was 1.94±1 cm (p < 0.001) after treatments however, no significant difference was seen between groups in terms of tumor size reduction. Retreatment rates were 3.1% (1 of 32 cases) in group A and 14.3% (2 of 14 cases) in group B (p = 0.21). No significant difference was found between groups in terms of bleeding and complication rates during the perioperative period. Mean follow-up duration was 26.48±25.71 (range from 2 to 102) months. CONCLUSION In this study, no clear supplementary benefit was observed in terms of safety, and efficacy with the adjunction of coils to distal particle embolization in the management of AMLs.
本研究评估了血管内治疗肾血管平滑肌脂肪瘤（AML）的单中心结果，以确定在安全性、疗效和再治疗率方面，近端线圈栓塞加远端颗粒栓塞是否具有临床意义。方法：回顾性分析 2007 年 1 月至 2020 年 10 月期间接受经动脉栓塞治疗的肾 AML 患者。记录患者和肿瘤特征、栓塞技术、治疗结果和并发症的相关参数。根据治疗中使用的栓塞剂类型，将患者分为 A 组（仅颗粒组）和 B 组（颗粒+线圈组）。对两组之间肿瘤体积缩小、再治疗和并发症发生率进行比较分析。结果：本研究共纳入 42 例（37 例女性，11.9%为男性）48 个 AML 患者。平均年龄为 43.46 岁（20-78 岁）。技术成功率为 95.8%（46/48 例）。治疗后平均肿瘤缩小 1.94±1cm（p<0.001），但两组之间肿瘤体积缩小无显著差异。A 组再治疗率为 3.1%（32 例中有 1 例），B 组为 14.3%（14 例中有 2 例）（p=0.21）。两组在围手术期出血和并发症发生率方面无显著差异。平均随访时间为 26.48±25.71 个月（范围为 2-102 个月）。结论：在本研究中，在 AML 管理中，近端线圈栓塞加远端颗粒栓塞在安全性和疗效方面没有明显的附加益处。
