Selective arterial embolization of renal angiomyolipoma: comparing ethanol–lipiodol emulsion and polyvinyl alcohol particles as embolic agents

Abstract

PURPOSETo examine the effectiveness and safety of two embolic agents, an ethanol–lipiodol emulsion and polyvinyl alcohol (PVA) particles, for selective arterial embolization (SAE) of renal angiomyolipoma (AML).METHODSRetrospectively, we reviewed the medical records and imaging data of renal AML patients who received SAE in our hospitals between July 2007 and January 2018. Among those eligible for analysis were patients with complete medical information, preoperative and postoperative contrast-enhanced computed tomography scans, and follow-up data. An ethanol–lipiodol emulsion was used to embolize 15 AMLs, and PVA particles were used to embolize 16 AMLs. We compared the tumor responses and adverse events between the two embolization-agent groups.RESULTSAfter embolization, no significant differences were observed in the shrinkage rates: 34.2% ± 3.4% for the ethanol–lipiodol emulsion group and 26.3% ± 3.0% for the PVA particles group (P = 0.090). Minor post-embolization complications were also similar between the groups, and there were no severe adverse events. The length of hospital stay after SAE was 2.5 ± 0.5 days for the ethanol–lipiodol emulsion group and 1.9 ± 0.5 days for the PVA particles group and was not significantly different (P = 0.425).CONCLUSIONThe results showed that SAE with ethanol–lipiodol emulsion or PVA particles was safe and efficient in decreasing tumor size and controlling renal AML hemorrhage.

Keywords

• angiomyolipoma
• embolization
• ethanol
• kidney
• polyvinyl alcohol