Renal angiomyolipoma: Embolotherapy with a mixture of alcohol and iodized oil
Renal angiomyolipoma: Embolotherapy with a mixture of alcohol and iodized oil
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DOI：
10.1016/s1051-0443(98)70266-0
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发表时间：
1998-03-01
影响因子：
2.9
通讯作者：
Park, JH
中科院分区：
文献类型：
--
作者：
Lee, W;Kim, TS;Park, JH
目的：评价以碘化油与无水乙醇1:3混合液为栓塞材料进行超选择性栓塞治疗肾血管平滑肌脂肪瘤的疗效。材料与方法：对15例21例有症状的肾血管平滑肌脂肪瘤患者进行栓塞治疗。肿瘤大小为6cm～15cm（平均8.6cm）。 15 名患者中有 6 名被诊断为结节性硬化症，肾血管平滑肌脂肪瘤的诊断是根据特征性计算机断层扫描结果做出的，所有血管平滑肌脂肪瘤均用碘油和无水乙醇 1:3 混合物（2-20 mL；平均 8.5 mL）成功栓塞。患者随访5个月至8年（平均35.6个月），通过无症状期、即刻和晚期并发症以及随访影像学检查结果（包括肿瘤大小的变化）评估栓塞治疗的疗效。结果：13例患者在3个月至8年的随访期间未出现症状复发。 2例栓塞不完全患者因肾周血肿或其他症状复发，需要重复栓塞。 12 例患者出现轻度栓塞后综合征，经保守治疗后症状消退，1 例患者出现中量胸腔积液，经皮引流治疗，无患者出现任何严重的晚期并发症、高血压或肾功能衰竭。随访期间，12例肿瘤体积缩小，8例肿瘤无变化，1例肿瘤未进行影像学随访。结论：碘油与无水乙醇1:3混合液栓塞治疗肾血管平滑肌脂肪瘤是一种有效的治疗方法，效果良好，但血管平滑肌脂肪瘤栓塞不完全导致出血复发症状的发生率较高。
PURPOSE: To evaluate the efficacy of superselective embolotherapy of renal angiomyolipomas with a 1:3 mixture of iodized oil and absolute ethanol as embolic material.MATERIALS AND METHODS: Fifteen patients with 21 symptomatic renal angiomyolipomas were treated with embolization. The sizes of tumors ranged from 6 cm to 15 cm (mean, 8.6 cm). Six of 15 patients were diagnosed with tuberous sclerosis, The diagnoses of renal angiomyolipoma were made from characteristic computed tomographic findings, All angiomyolipomas were successfully embolized with a 1:3 mixture of iodized oil and absolute ethanol (2-20 mL; mean, 8.5 mL). Patients were followed up from 5 months to 8 years (mean, 35.6 months), The efficacy of embolotherapy was evaluated by symptom-free period, immediate and late complications, and follow-up imaging findings, including changes in tumor size.RESULTS: Thirteen patients showed no symptom recurrence during follow-up periods from 3 months to 8 years. Two patients with incomplete embolization required repeated embolization because of the recurrence of perinephric hematoma or other symptoms. Twelve patients experienced mild postembolization syndrome, which subsided with conservative management, A moderate amount of pleural effusion developed in one patient and was managed with percutaneous drainage, No patients developed any severe late complications, hypertension, or renal failure. During the follow-up period, 12 tumors decreased in size, whereas there was no change in eight tumors, and in one tumor imaging follow-up was not available.CONCLUSION: Embolization with a 1:3 mixture of iodized oil and absolute ethanol is an effective method of treatment in renal angiomyolipoma with favorable results, But incomplete embolization of angiomyolipoma results in a high incidence of recurrent symptoms due to bleeding.