Experience with transarterial embolization for large symptomatic renal angiomyolipomas in patients with a solitary kidney: long-term outcomes.

IF 2 4区医学 Q2 SURGERY

Minimally Invasive Therapy & Allied Technologies Pub Date : 2025-06-27 DOI:10.1080/13645706.2025.2523257

Heng Zhang, Jin Xin Fu, Jin Long Zhang, Li Min Meng, Xi Long Yu, Mao Qiang Wang

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Abstract

Background: Treatment of large symptomatic renal angiomyolipomas (AMLs) in patients with a solitary kidney poses a challenge in controlling the tumor while preserving renal function. This retrospective research examines the safety and long-term effects of transarterial embolization (TAE) using iodized oil-bleomycin emulsion plus N-Butyl cyanoacrylate (NBCA) for treating large symptomatic AMLs in patients with a solitary kidney.

Methods: Over 20 years, 12 female patients, who had a solitary kidney due to a previous radical nephrectomy for AMLs, underwent TAE. Indications included symptomatic AMLs (retroperitoneal hematoma, hematuria or flank pain) and patients considered very high-risk for surgery (≥5 cm). The study evaluated adverse events (AEs), renal function changes, symptom relief, and tumor size.

Results: The median follow-up was 96 months. No significant kidney function decline was noted. Symptoms resolved completely in all patients, with the mean lesion diameter reducing from 7.2 ± 2.5 cm to 0.7 ± 0.5 cm (p < 0.01). Complete resolution (CR) of AMLs occurred in nine patients (83.3%), with no recurrence during follow-up.

Conclusions: TAE with iodized oil-bleomycin emulsion plus NBCA for treatment with large symptomatic AMLs in solitary kidney is safe and durability effect, with complete resolution of the symptoms, high rate CR of the tumors, without deterioration of the renal function.

Trial registration: ChiCTR2100053296.

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经动脉栓塞治疗单肾患者大症状性肾血管平滑肌脂肪瘤的经验：长期结果。

背景：孤立肾患者的大症状性肾血管平滑肌脂肪瘤（AMLs）的治疗在控制肿瘤的同时保持肾功能是一个挑战。本回顾性研究探讨了碘化油-博来霉素乳剂加n -氰基丙烯酸酯丁酯（NBCA）经动脉栓塞（TAE）治疗孤立肾患者症状性大aml的安全性和长期效果。方法：在过去的20年里，12名女性患者因AMLs的根治性肾切除术而有一个孤立的肾脏，接受了TAE。适应症包括有症状的aml（腹膜后血肿、血尿或侧腹疼痛）和高危手术患者（≥5 cm）。该研究评估了不良事件（ae）、肾功能改变、症状缓解和肿瘤大小。结果：中位随访时间为96个月。肾功能未见明显下降。所有患者症状完全缓解，平均病灶直径由7.2±2.5 cm减小至0.7±0.5 cm (p)。结论：TAE联合碘化油博来霉素乳剂联合NBCA治疗孤立性肾大症状性aml，疗效安全、持久，症状完全缓解，肿瘤成形率高，无肾功能恶化。试验注册：ChiCTR2100053296。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.