RENAL ANGIOMYOLIPOMAS - LONG-TERM FOLLOW-UP OF EMBOLIZATION FOR ACUTEHEMORRHAGE

Objective: To determine if elective, angiographically directed emboliz ation of enlarged renal angiomyolipomas can be used to prevent future hemorrhagic episodes in patients with tuberous sclerosis and thus avoi d nephrectomy. Patients and methods: Records were reviewed for all 5 p atients who underwent elective, subtotal embolization of large, sympto matic angiomyolipomas at the authors' institution between 1975 and 199 6. Results: All 5 patients had tuberous sclerosis and bilateral renal angiomyolipomas. Initial embolization in these patients was performed in 1975, 1981, 1993 (2 patients) and 1994. In 1 patient only a single embolization session was required. In another, initial embolization on the left side was followed by embolization on the right 13 months lat er, Two patients underwent 2 sessions, and 1 patient had 4 sessions ov er a 13-year period. Subtotal embolization with particulate material l ed to a decrease in size of the most severely affected portion of the kidney. One large angiomyolipoma underwent sterile liquefaction after embolization; percutaneous catheter drainage was required. The emboliz ation allowed subsequent partial nephrectomy in this patient, Conclusi on: Embolization is effective for the long-term management of renal an giomyolipomas in patients with tuberous sclerosis; in this way nephrec tomy and loss of renal function can usually be avoided.