Selective arterial embolization for renal angiomyolipoma: The role of optimal embolization
Articles > Article · 2026
Authors: Celal ÇİNAR, Mahmut KÜSBECİ, ALPEREN ELEK, İsmail ORAN, EGEMEN ÖZTÜRK, FERHAT KIRAN, UMUT DENİZ PAK
Ege Tıp Dergisi, National Refreed University Journal, International, TR DİZİN (ULAKBİM), 2026, vol 65, pp 538-546
DOI: 10.19161/etd.1890963
Summary
Aim: The study aims to evaluate the efficacy and safety of selective arterial embolization (SAE) for renal angiomyolipoma (rAML).Material and Methods: This retrospective study included patients with rAML who underwent SAE between February 2009 and December 2022. The primary outcome was procedural success, defined as cessation of bleeding and reduction in tumor size. Secondary outcomes included complication rates, changes in symptoms, and the need for reintervention. Kaplan-Meier analysis was performed to assess reintervention-free survival.Results: A total of 42 patients with 62 rAMLs were included, with a mean age of 43.9 ± 12.2 years (range: 23–68). The majority were female (80.9%, n = 34), and 18.1% (n = 8) had TSC-associated rAML. TSC-associated cases presented at a younger age and had Table 2/Results give volume p=0.007, not 0.002 (0.002 is for size)., lower hemoglobin levels (p = 0.02), and higher creatinine levels (p = 0.05) compared to sporadic rAML cases. SAE achieved a 100% technical success rate. The mean hospitalization duration was 4.16 ± 4.04 days, and no major complications were observed. The mean follow-up period was 35.27 ± 37.67 months. During follow-up, 6 patients (14.3%) required reintervention, including 4 re-embolizations and 2 surgical procedures. The overall Kaplan-Meier estimate of freedom from reintervention at 4.6 years was 68%, with significantly higher reintervention rates in TSC-associated cases (p = 0.04). When comparing embolization techniques, optimal embolization (coils + polyvinyl alcohol [PVA] particles) resulted. This p-value (0.049) is a between-group baseline volume comparison not a volume-reduction. Can you please write ‘significantly greater baseline volume (p = 0.049). In contrast, non-optimal embolization (coils or PVA alone) p=0.059 is not significant at your stated α=0.05 — 'less significant' implies it is. Please write: 'did not reach statistical significance reduction in maximum lesion diameter (p = 0.059). Despite this, there was no significant difference in pre- and post-procedure laboratory parameters between the two embolization groups, except for lesion volume.Conclusions: SAE is effective for managing rAMLs, with high technical success and acceptable re-intervention rates. Optimal embolization plays a pivotal role in enhancing treatment efficacy.