Renal Angiomyolipoma: Mid- to Long-Term Results Following Embolization with Onyx

Cardiovasc Intervent Radiol. 2016 Dec;39(12):1759-1764. doi: 10.1007/s00270-016-1432-0. Epub 2016 Jul 28.

Abstract

Purpose: Percutaneous transcatheter embolization is currently the preferred treatment for ruptured or enlarging renal angiomyolipoma (AML), although the optimum choice of embolic material has not yet been established. We present mid- to long-term outcomes following embolization of AMLs with Onyx.

Materials and methods: Ten AMLs in seven patients (including two with tuberous sclerosis) were embolized with Onyx. Patients were followed-up clinically, with tumour size and renal function measured pre- and post-procedure.

Results: Mean pre-treatment AML size was 63.4 mm (range 42-100). Mean clinical follow-up was 431.4 days (range 153-986) and imaging follow-up 284.2 days (range 30-741). There was no haemorrhage from treated lesions within the follow-up period. Of patients who had cross-sectional imaging pre- and post-procedure, mean decrease in AML size of 22 mm was seen after Onyx embolization (p = 0.0058, 95 % CI 9.13-34.87). No significant difference between serum creatinine was seen pre- and post-procedure (p = 0.54, 95 % CI 8.63-4.85).

Conclusions: Onyx embolization of renal AMLs is effective in the medium to long term, with theoretical benefits in safety and durability of result.

Keywords: Angiomyolipoma; Arterial embolization; Ethylene vinyl alcohol copolymer; Onyx; Tuberous sclerosis.

MeSH terms

  • Adult
  • Aged
  • Angiomyolipoma / therapy*
  • Drug Combinations
  • Embolization, Therapeutic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Neoplasms / therapy*
  • Male
  • Middle Aged
  • Polyvinyls / therapeutic use*
  • Tantalum / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • Drug Combinations
  • Onyx 18
  • Polyvinyls
  • Tantalum