Selective arterial embolization in the management of symptomatic renal angiomyolipomas

Current management of renal angiomyolipomas (AMLs) include observation, tra nscatheter embolization and partial or total nephrectomy. Patients symptoms and size of the lesion are the determinants for the choice of the treatmen t. In general symptomatic or greater than 8 cm masses require intervention. A retrospective study of five patients presented with symptomatic lesions and treated with selective transcatheter embolization, over a 3 year period was performed in our hospital. A total of eight embolizations were perform ed, all on an emergency basis due to retroperitoneal bleeding or significan t hematuria. Surgical intervention was necessary in one case, due to massiv e rebleeding on the fourth post-procedural day. Two patients rebled within 6 months and 2 years respectively, and were managed successfully with addit ional embolization. The remaining two patients are still asymptomatic 26 an d 18 months after the successful initial result. Experience with this proce dure is reported on with emphasis to the clinical outcome. It is believed t hat selective arterial embolization should be the standard initial therapy for symptomatic renal AMLs. (C) 1999 Elsevier Science Ireland Ltd. Ail righ ts reserved.