Elective embolization for prevention of hemorrhage from renal angiomyolipomas

Abstract

Purpose: 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.

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

Results: 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.

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