A new management strategy for renal angiomyolipomas: superselective arterial embolization in combination with radiofrequency ablation

Fengyong Liu, Hongjun Yuan, Xin Li, Jing Tang, Xiaomei Tian, Kan Ji


Background: The present study analyzed the safety and efficacy of superselective arterial embolization (SAE) combined with radiofrequency ablation (RFA) to treat renal angiomyolipoma (RAML).
Methods: This retrospective study included the clinical data of 6 patients with RAML treated between March 2016 and October 2017. All patients underwent RFA treatment immediately after SAE guided by angio-computed tomography (angio-CT). The tumor size, renal function and complications, and time to recurrence were compared before and after treatment.
Results: The success rate of the SAE + RFA technique was 100%, and no serious complications were found during or after surgery. After treatment, the patients’ symptoms, including low back pain and hematuria, were relieved. The pre-treatment creatinine level (55.6±11.0 μmol/L) did not differ significantly from the post-treatment creatinine level (68.2±13.7 μmol/L), which was measured 1 day after surgery (t=1.75, P=0.109). The mean follow-up time was 29.5±6.1 months. By the end of the follow-up period, the maximum diameter of the tumor was 3.1±0.6 cm, which was significantly smaller than the pre-treatment diameter of 5.9±1.01 cm (t=5.83, P<0.001). At 3 months after surgery, the maximum diameter of the tumor was reduced by 22–38% in all 6 patients. At the last follow-up examination, the maximum diameter of the tumor was reduced by 36–61%. Contrast-enhanced CT or magnetic resonance imaging scans showed that the enhanced part of the original lesion had disappeared, the renal parenchyma was full of even fat signals, and only one patient had new enhanced lesions at the site of the original lesions.
Conclusions: SAE combined with RFA is a safe and effective treatment for RAML, and its strengths qualify it to become a new treatment strategy for RAML.