Polyvinyl alcohol and N-butyl cyanoacrylate for transarterial embolization of ruptured renal angiomyolipomas

Abstract

Objective: To evaluate using of polyvinyl alcohol particle and N-butyl cyanoacrylate (NBCA)/lipiodol mixture for selective embolization of eight patients with ruptured renal angiomyolipomas (AMLs). Patients and methods: From January 2006 to December 2012, eight patients underwent angiography and embolization of renal angiomyolipoma-associated hemorrhage. The patients were 7 women and one man, 22–52 years old. Only 2 patients had the sporadic form of angiomyolipoma and the other 6 patients had the tuberous sclerosis form. Two patients presented with hematuria, while the other 6 patients presented with perinephric bleed. Three patients were treated urgently, while the other 5 patients were scheduled for embolization 1–3 days after admission. The technical and clinical success, complications, rebleeding and the need for surgical intervention were documented. Results: Angiography showed aneurysmal dilatation in 7 patients (88%). Twenty-five feeding arteries were embolized. Primary technical success rate was 62.5% and the clinical success rate was 100%. No major complications or deaths occurred during or after the procedures. Mean hospitalization was 5 (range 3–12) days. Secondary technical success rate was 100%. No tumor growth on the follow up CT and the mean size reduction was 41%. Conclusion: Selective arterial embolization with polyvinyl alcohol particles and N-butyl cyanoacrylate/lipiodol mixture is an effective and safe treatment for patients with ruptured renal AMLs