Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction
Abstract Background Transcatheter arterial embolization (TAE) has been widely performed for renal angiomyolipomas (AMLs) as prophylaxis or emergency treatment. On the other hand, mammalian target of rapamycin (mTOR) inhibitors have recently been used for tuberous sclerosis (TSC)-related AMLs, and no...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-11-01
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| Series: | CVIR Endovascular |
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| Online Access: | http://link.springer.com/article/10.1186/s42155-020-00179-2 |
| _version_ | 1818531702504423424 |
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| author | Hidenari Hongyo Hiroki Higashihara Keigo Osuga Eiji Kashiwagi Shinya Kosai Keisuke Nagai Kaishu Tanaka Yusuke Ono Takeshi Ujike Motohide Uemura Ryoichi Imamura Norio Nonomura Noriyuki Tomiyama |
| author_facet | Hidenari Hongyo Hiroki Higashihara Keigo Osuga Eiji Kashiwagi Shinya Kosai Keisuke Nagai Kaishu Tanaka Yusuke Ono Takeshi Ujike Motohide Uemura Ryoichi Imamura Norio Nonomura Noriyuki Tomiyama |
| author_sort | Hidenari Hongyo |
| collection | DOAJ |
| description | Abstract Background Transcatheter arterial embolization (TAE) has been widely performed for renal angiomyolipomas (AMLs) as prophylaxis or emergency treatment. On the other hand, mammalian target of rapamycin (mTOR) inhibitors have recently been used for tuberous sclerosis (TSC)-related AMLs, and no comparison between the effectiveness of mTOR inhibitors versus prophylactic selective TAE has yet been performed. Therefore, the purpose of this study was to evaluate the efficacy of TAE for AML tumor volume reduction and predictors of tumor volume decrease over 50%, with reference to the EXIST-2 trial. Methods A total of 44 patients who underwent 48 prophylactic embolization procedures for 50 AMLs in a single institution between 2004 and 2018 were included. Indications for TAE of AMLs were tumor size ≥4 cm or aneurysm ≥5 mm in diameter on contrast-enhanced computed tomography (CECT). Microspheres, ethanol, and micro-coils were used as embolic agents. The percentage volume reduction from before TAE to the minimum volume during follow-up after TAE was calculated, and predictors for 50% volume reduction were identified by univariate and multivariate binary logistic regression analyses. Results The technical success rate was 100% (50 of 50). No severe acute complications related to the procedure were encountered. Tumor volume reduction of ≥50% was observed in 35/50 AMLs. There was a significant difference in the rate of tumor volume reduction of 50% between the presence and absence of an aneurysm ≥5 mm and between tumor diameter ≥ 70 mm and < 70 mm on univariate analysis. On multivariate analysis, tumor diameter < 70 mm was the only independent predictor of significant tumor volume reduction after TAE. Conclusion Prophylactic selective TAE for AMLs has good tumor-reduction effects, especially for AMLs with tumor diameter < 70 mm. |
| first_indexed | 2024-12-11T17:35:54Z |
| format | Article |
| id | doaj.art-98cb62b7ecf54767a1c11521fbc65143 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-12-11T17:35:54Z |
| publishDate | 2020-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-98cb62b7ecf54767a1c11521fbc651432022-12-22T00:56:40ZengSpringerOpenCVIR Endovascular2520-89342020-11-01311710.1186/s42155-020-00179-2Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reductionHidenari Hongyo0Hiroki Higashihara1Keigo Osuga2Eiji Kashiwagi3Shinya Kosai4Keisuke Nagai5Kaishu Tanaka6Yusuke Ono7Takeshi Ujike8Motohide Uemura9Ryoichi Imamura10Norio Nonomura11Noriyuki Tomiyama12Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineDepartment of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineDepartment of Diagnostic Radiology, Osaka Medical CollegeDepartment of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineDepartment of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineDepartment of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineDepartment of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineDepartment of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineDepartment of Urology, Osaka University Graduate School of MedicineDepartment of Urology, Osaka University Graduate School of MedicineDepartment of Urology, Osaka University Graduate School of MedicineDepartment of Urology, Osaka University Graduate School of MedicineDepartment of Diagnostic and Interventional Radiology, Osaka University Graduate School of MedicineAbstract Background Transcatheter arterial embolization (TAE) has been widely performed for renal angiomyolipomas (AMLs) as prophylaxis or emergency treatment. On the other hand, mammalian target of rapamycin (mTOR) inhibitors have recently been used for tuberous sclerosis (TSC)-related AMLs, and no comparison between the effectiveness of mTOR inhibitors versus prophylactic selective TAE has yet been performed. Therefore, the purpose of this study was to evaluate the efficacy of TAE for AML tumor volume reduction and predictors of tumor volume decrease over 50%, with reference to the EXIST-2 trial. Methods A total of 44 patients who underwent 48 prophylactic embolization procedures for 50 AMLs in a single institution between 2004 and 2018 were included. Indications for TAE of AMLs were tumor size ≥4 cm or aneurysm ≥5 mm in diameter on contrast-enhanced computed tomography (CECT). Microspheres, ethanol, and micro-coils were used as embolic agents. The percentage volume reduction from before TAE to the minimum volume during follow-up after TAE was calculated, and predictors for 50% volume reduction were identified by univariate and multivariate binary logistic regression analyses. Results The technical success rate was 100% (50 of 50). No severe acute complications related to the procedure were encountered. Tumor volume reduction of ≥50% was observed in 35/50 AMLs. There was a significant difference in the rate of tumor volume reduction of 50% between the presence and absence of an aneurysm ≥5 mm and between tumor diameter ≥ 70 mm and < 70 mm on univariate analysis. On multivariate analysis, tumor diameter < 70 mm was the only independent predictor of significant tumor volume reduction after TAE. Conclusion Prophylactic selective TAE for AMLs has good tumor-reduction effects, especially for AMLs with tumor diameter < 70 mm.http://link.springer.com/article/10.1186/s42155-020-00179-2Kidney neoplasmsAngiomyolipomaEmbolizationTherapeuticTuberous sclerosis |
| spellingShingle | Hidenari Hongyo Hiroki Higashihara Keigo Osuga Eiji Kashiwagi Shinya Kosai Keisuke Nagai Kaishu Tanaka Yusuke Ono Takeshi Ujike Motohide Uemura Ryoichi Imamura Norio Nonomura Noriyuki Tomiyama Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction CVIR Endovascular Kidney neoplasms Angiomyolipoma Embolization Therapeutic Tuberous sclerosis |
| title | Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction |
| title_full | Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction |
| title_fullStr | Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction |
| title_full_unstemmed | Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction |
| title_short | Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction |
| title_sort | efficacy of prophylactic selective arterial embolization for renal angiomyolipomas identifying predictors of 50 volume reduction |
| topic | Kidney neoplasms Angiomyolipoma Embolization Therapeutic Tuberous sclerosis |
| url | http://link.springer.com/article/10.1186/s42155-020-00179-2 |
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