Renal angiomyolipomas: long-term follow-up of embolization for acute hemorrhage

Can Assoc Radiol J. 1997 Jun;48(3):191-8.


Objective: To determine if elective, angiographically directed embolization of enlarged renal angiomyolipomas can be used to prevent future hemorrhagic episodes in patients with tuberous sclerosis and thus avoid nephrectomy.

Patients and methods: Records were reviewed for all 5 patients who underwent elective, subtotal embolization of large, symptomatic angiomyolipomas at the authors' institution between 1975 and 1996.

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 later. Two patients underwent 2 sessions, and 1 patient had 4 sessions over a 13-year period. Subtotal embolization with particulate material led 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 embolization allowed subsequent partial nephrectomy in this patient.

Conclusion: Embolization is effective for the long-term management of renal angiomyolipomas in patients with tuberous sclerosis; in this way nephrectomy and loss of renal function can usually be avoided.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Angiography
  • Angiomyolipoma / surgery
  • Angiomyolipoma / therapy*
  • Child
  • Embolization, Therapeutic* / methods
  • Female
  • Follow-Up Studies
  • Hematuria / prevention & control
  • Hemorrhage / prevention & control*
  • Humans
  • Kidney Diseases / prevention & control*
  • Kidney Neoplasms / surgery
  • Kidney Neoplasms / therapy*
  • Longitudinal Studies
  • Male
  • Nephrectomy / methods
  • Nephrostomy, Percutaneous
  • Radiography, Interventional
  • Tuberous Sclerosis / complications