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Published in: CardioVascular and Interventional Radiology 5/2014

01-10-2014 | Clinical Investigation

Evaluation of Split Renal Function Before and After Renal Arterial Embolization for Angiomyolipoma Using Absolute Ethanol

Authors: Yasutaka Baba, Sadao Hayashi, Shunichiro Ikeda, Megumi Jinguji, Masatoyo Nakajo, Masayuki Nakajo

Published in: CardioVascular and Interventional Radiology | Issue 5/2014

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Abstract

Purpose

Transcatheter arterial embolization (TAE) with absolute ethanol is widely accepted as a therapeutic procedure for renal angiomyolipoma (AML). We aim to evaluate the split renal function before and after AE for renal AML by using 99m-technetium (99mTc)-mercaptoacetyltriglycine 3 (MAG3) renography.

Methods

This study was approved by the Institutional Review Board. The study population comprised 11 renal AML patients (three males, eight females, age 55.1 ± 13.8 years, AML in eight right and three left kidneys) who received unilateral renal TAE with absolute ethanol from April 2002 to January 2013. Blood renal function (i.e. serum creatinine and estimated glomerular filtration rate [eGFR] and split effective renal plasma flow [ERPF]) calculated on 99mTc-MAG3 renography was compared before and within 1 week after renal AE. Statistical analysis was calculated using Wilcoxon signed-ranked test.

Results

TAE for renal AML was technically successful in all patients. Serum creatinine and eGFR did not change before and after TAE. ERPF on the embolized kidney did not change before (127.3 ± 60.8 ml/min) and after (127.6 ± 47.4 ml/min) TAE (p = 0.9726). ERPF on the nonembolized kidney showed a statistically significant increase before (152.5 ± 46.8 ml/min) and within 1 week after (169.1 ± 41.5 ml/min) TAE (p = 0.0093 and p < 0.05, respectively).

Conclusion

TAE for renal AML may not induce renal dysfunction on the embolized kidney and may immediately increase the renal blood flow of the nonembolized kidney.
Literature
2.
go back to reference Seyam RM, Bissada NK, Kattan SA et al (2008) Changing trends in presentation, diagnosis and management of renal angiomyolipoma: comparison of sporadic and tuberous sclerosis complex-associated forms. Urology 72:1077–1082PubMedCrossRef Seyam RM, Bissada NK, Kattan SA et al (2008) Changing trends in presentation, diagnosis and management of renal angiomyolipoma: comparison of sporadic and tuberous sclerosis complex-associated forms. Urology 72:1077–1082PubMedCrossRef
3.
go back to reference Rakowski SK, Winterkorn EB, Paul E, Steele DJ, Halpern EF, Thiele EA (2006) Renal manifestations of tuberous sclerosis complex: incidence, prognosis, and predictive factors. Kidney Int 70:1777–1782PubMedCrossRef Rakowski SK, Winterkorn EB, Paul E, Steele DJ, Halpern EF, Thiele EA (2006) Renal manifestations of tuberous sclerosis complex: incidence, prognosis, and predictive factors. Kidney Int 70:1777–1782PubMedCrossRef
4.
go back to reference Williams JM, Racadio JM, Johnson ND, Donnelly LF, Bissler JJ (2006) Embolization of renal angiomyolipomata in patients with tuberous sclerosis complex. Am J Kidney Dis 47:95–102PubMedCrossRef Williams JM, Racadio JM, Johnson ND, Donnelly LF, Bissler JJ (2006) Embolization of renal angiomyolipomata in patients with tuberous sclerosis complex. Am J Kidney Dis 47:95–102PubMedCrossRef
5.
go back to reference Gould Rothberg BE, Grooms MC, Dharnidharka VR (2006) Rapid growth of a kidney angiomyolipoma after initiation of oral contraceptive therapy. Obstet Gynecol 108:734–736PubMedCrossRef Gould Rothberg BE, Grooms MC, Dharnidharka VR (2006) Rapid growth of a kidney angiomyolipoma after initiation of oral contraceptive therapy. Obstet Gynecol 108:734–736PubMedCrossRef
6.
go back to reference Zapardiel I, Delafuente-Valero J, Bajo-Arenas JM (2011) Renal angiomyolipoma during pregnancy: review of the literature. Gynecol Obstet Invest 72:217–219PubMedCrossRef Zapardiel I, Delafuente-Valero J, Bajo-Arenas JM (2011) Renal angiomyolipoma during pregnancy: review of the literature. Gynecol Obstet Invest 72:217–219PubMedCrossRef
7.
go back to reference Kennelly MJ, Grossman HB, Cho KJ (1994) Outcome analysis of 42 cases of renal angiomyolipoma. J Urol 152:1988–1991PubMed Kennelly MJ, Grossman HB, Cho KJ (1994) Outcome analysis of 42 cases of renal angiomyolipoma. J Urol 152:1988–1991PubMed
8.
go back to reference Msezane L, Chang A, Shikanov S et al (2010) Laparoscopic nephron-sparing surgery in the management of angiomyolipoma: a single center experience. J Endourol 24:583–587PubMedCrossRef Msezane L, Chang A, Shikanov S et al (2010) Laparoscopic nephron-sparing surgery in the management of angiomyolipoma: a single center experience. J Endourol 24:583–587PubMedCrossRef
9.
go back to reference Kothary N, Soulen MC, Clark TW et al (2005) Renal angiomyolipoma: long-term results after arterial embolization. J Vasc Interv Radiol 16:45–50PubMedCrossRef Kothary N, Soulen MC, Clark TW et al (2005) Renal angiomyolipoma: long-term results after arterial embolization. J Vasc Interv Radiol 16:45–50PubMedCrossRef
10.
go back to reference Chan CK, Yu S, Yip S, Lee P (2011) The efficacy, safety and durability of selective renal arterial embolization in treating symptomatic and asymptomatic renal angiomyolipoma. Urology 77:642–648PubMedCrossRef Chan CK, Yu S, Yip S, Lee P (2011) The efficacy, safety and durability of selective renal arterial embolization in treating symptomatic and asymptomatic renal angiomyolipoma. Urology 77:642–648PubMedCrossRef
11.
go back to reference Chatziioannou A, Gargas D, Malagari K et al (2012) Transcatheter arterial embolization as therapy of renal angiomyolipomas: the evolution in 15 years of experience. Eur J Radiol 81:2308–2312PubMedCrossRef Chatziioannou A, Gargas D, Malagari K et al (2012) Transcatheter arterial embolization as therapy of renal angiomyolipomas: the evolution in 15 years of experience. Eur J Radiol 81:2308–2312PubMedCrossRef
12.
go back to reference Chick CM, Tan BS, Cheng C et al (2010) Long-term follow-up of the treatment of renal angiomyolipomas after selective arterial embolization with alcohol. BJU Int 105:390–394PubMedCrossRef Chick CM, Tan BS, Cheng C et al (2010) Long-term follow-up of the treatment of renal angiomyolipomas after selective arterial embolization with alcohol. BJU Int 105:390–394PubMedCrossRef
13.
go back to reference Incedayi M, Turba UC, Arslan B et al (2010) Endovascular therapy for patients with renal angiomyolipoma presenting with retroperitoneal haemorrhage. Eur J Vasc Endovasc Surg 39:739–744PubMedCrossRef Incedayi M, Turba UC, Arslan B et al (2010) Endovascular therapy for patients with renal angiomyolipoma presenting with retroperitoneal haemorrhage. Eur J Vasc Endovasc Surg 39:739–744PubMedCrossRef
14.
go back to reference Villalta JD, Sorensen MD, Durack JC, Kerlan RK, Stoller ML (2011) Selective arterial embolization of angiomyolipomas: a comparison of smaller and larger embolic agents. J Urol 186:921–927PubMedCrossRef Villalta JD, Sorensen MD, Durack JC, Kerlan RK, Stoller ML (2011) Selective arterial embolization of angiomyolipomas: a comparison of smaller and larger embolic agents. J Urol 186:921–927PubMedCrossRef
15.
go back to reference Ramon J, Rimon U, Garniek A et al (2009) Renal angiomyolipoma: long-term results following selective arterial embolization. Eur Urol 55:1155–1161PubMedCrossRef Ramon J, Rimon U, Garniek A et al (2009) Renal angiomyolipoma: long-term results following selective arterial embolization. Eur Urol 55:1155–1161PubMedCrossRef
16.
go back to reference Lee SY, Hsu HH, Chen YC et al (2009) Embolization of renal angiomyolipomas: short-term and long-term outcomes, complications, and tumor shrinkage. Cardiovasc Interv Radiol 32:1171–1178CrossRef Lee SY, Hsu HH, Chen YC et al (2009) Embolization of renal angiomyolipomas: short-term and long-term outcomes, complications, and tumor shrinkage. Cardiovasc Interv Radiol 32:1171–1178CrossRef
17.
go back to reference Lenton J, Kessel D, Watkinson AF (2008) Embolization of renal angiomyolipoma: immediate complications and long-term outcomes. Clin Radiol 63:864–870PubMedCrossRef Lenton J, Kessel D, Watkinson AF (2008) Embolization of renal angiomyolipoma: immediate complications and long-term outcomes. Clin Radiol 63:864–870PubMedCrossRef
18.
go back to reference Chang YH, Wang LJ, Chuang CK, Wong YC, Wu CT, Hsieh ML (2007) The efficacy and outcomes of urgent superselective transcatheter arterial embolization of patients with ruptured renal angiomyolipomas. J Trauma 62:1487–1490PubMedCrossRef Chang YH, Wang LJ, Chuang CK, Wong YC, Wu CT, Hsieh ML (2007) The efficacy and outcomes of urgent superselective transcatheter arterial embolization of patients with ruptured renal angiomyolipomas. J Trauma 62:1487–1490PubMedCrossRef
19.
go back to reference Rimon U, Duvdevani M, Garniek A et al (2006) Ethanol and polyvinyl alcohol mixture for transcatheter embolization of renal angiomyolipoma. AJR Am J Roentgenol 187:762–768PubMedCrossRef Rimon U, Duvdevani M, Garniek A et al (2006) Ethanol and polyvinyl alcohol mixture for transcatheter embolization of renal angiomyolipoma. AJR Am J Roentgenol 187:762–768PubMedCrossRef
20.
go back to reference Mourikis D, Chatziioannou A, Antoniou A, Kehagias D, Gikas D, Vlahos L (1999) Selective arterial embolization in the management of symptomatic renal angiomyolipomas. Eur J Radiol 32:153–159PubMedCrossRef Mourikis D, Chatziioannou A, Antoniou A, Kehagias D, Gikas D, Vlahos L (1999) Selective arterial embolization in the management of symptomatic renal angiomyolipomas. Eur J Radiol 32:153–159PubMedCrossRef
21.
go back to reference Han YM, Kim JK, Roh BS et al (1997) Renal angiomyolipoma: selective arterial embolization—effectiveness and changes in angiomyogenic components in long-term follow-up. Radiology 204:65–70PubMedCrossRef Han YM, Kim JK, Roh BS et al (1997) Renal angiomyolipoma: selective arterial embolization—effectiveness and changes in angiomyogenic components in long-term follow-up. Radiology 204:65–70PubMedCrossRef
22.
go back to reference Prevoo W, van den Bosch MA, Horenblas S (2008) Radiofrequency ablation for treatment of sporadic angiomyolipoma. Urology 72:188–191PubMedCrossRef Prevoo W, van den Bosch MA, Horenblas S (2008) Radiofrequency ablation for treatment of sporadic angiomyolipoma. Urology 72:188–191PubMedCrossRef
23.
go back to reference Planche O, Correas JM, Mader B, Joly D, Mejean A, Helenon O (2011) Prophylactic embolization of renal angiomyolipomas: evaluation of therapeutic response using CT 3D volume calculation and density histograms. J Vasc Interv Radiol 22:1388–1395PubMedCrossRef Planche O, Correas JM, Mader B, Joly D, Mejean A, Helenon O (2011) Prophylactic embolization of renal angiomyolipomas: evaluation of therapeutic response using CT 3D volume calculation and density histograms. J Vasc Interv Radiol 22:1388–1395PubMedCrossRef
24.
go back to reference Sanchez FW, Vujic I, Ayres RI, Curry NS, Gobien RP (1985) Hemorrhagic renal angiomyolipoma: superselective renal arterial embolization for preservation of renal function. Cardiovasc Interv Radiol 8:39–42CrossRef Sanchez FW, Vujic I, Ayres RI, Curry NS, Gobien RP (1985) Hemorrhagic renal angiomyolipoma: superselective renal arterial embolization for preservation of renal function. Cardiovasc Interv Radiol 8:39–42CrossRef
25.
go back to reference Lee SY, Hsu HH, Chen YC et al (2009) Evaluation of renal function of angiomyolipoma patients after selective transcatheter arterial embolization. Am J Med Sci 337:103–108PubMedCrossRef Lee SY, Hsu HH, Chen YC et al (2009) Evaluation of renal function of angiomyolipoma patients after selective transcatheter arterial embolization. Am J Med Sci 337:103–108PubMedCrossRef
26.
go back to reference Matsuo S, Imai E, Horio M et al (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53:982–992PubMedCrossRef Matsuo S, Imai E, Horio M et al (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53:982–992PubMedCrossRef
27.
go back to reference Itoh K, Tsukamoto E, Kakizaki H, Nonomura K, Furudate M (1993) Comparative study of renal scintigraphy with 99Tcm-mercaptoacetyltriglycine and 123I-orthoiodohippurate. Nucl Med Commun 14:644–652PubMedCrossRef Itoh K, Tsukamoto E, Kakizaki H, Nonomura K, Furudate M (1993) Comparative study of renal scintigraphy with 99Tcm-mercaptoacetyltriglycine and 123I-orthoiodohippurate. Nucl Med Commun 14:644–652PubMedCrossRef
28.
go back to reference Anderson RG, Bueschen AJ, Lloyd LK, Dubovsky EV, Burns JR (1991) Short-term and long-term changes in renal function after donor nephrectomy. J Urol 145:11–13PubMed Anderson RG, Bueschen AJ, Lloyd LK, Dubovsky EV, Burns JR (1991) Short-term and long-term changes in renal function after donor nephrectomy. J Urol 145:11–13PubMed
29.
go back to reference Shirasaki Y, Saika T, Tsushima T, Nasu Y, Arata R, Kumon H (2005) Predicting postoperative renal insufficiency in patients undergoing nephrectomy for renal malignancy: assessment by renal scintigraphy using 99mtechnetium-mercaptoacetyltriglycine. J Urol 173:388–390PubMedCrossRef Shirasaki Y, Saika T, Tsushima T, Nasu Y, Arata R, Kumon H (2005) Predicting postoperative renal insufficiency in patients undergoing nephrectomy for renal malignancy: assessment by renal scintigraphy using 99mtechnetium-mercaptoacetyltriglycine. J Urol 173:388–390PubMedCrossRef
30.
go back to reference Kanamaru H, Yamamoto M, Nagahama K et al (2011) Mercaptoacetyltriglycine-3 renogram is not superior to estimated glomerular filtration rate measurement for the prediction of long-term renal function after nephrectomy. Int J Urol 18:570–574PubMedCrossRef Kanamaru H, Yamamoto M, Nagahama K et al (2011) Mercaptoacetyltriglycine-3 renogram is not superior to estimated glomerular filtration rate measurement for the prediction of long-term renal function after nephrectomy. Int J Urol 18:570–574PubMedCrossRef
Metadata
Title
Evaluation of Split Renal Function Before and After Renal Arterial Embolization for Angiomyolipoma Using Absolute Ethanol
Authors
Yasutaka Baba
Sadao Hayashi
Shunichiro Ikeda
Megumi Jinguji
Masatoyo Nakajo
Masayuki Nakajo
Publication date
01-10-2014
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 5/2014
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-013-0780-2

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