Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 5, September-October, p. 837–843

doi: 10.17219/acem/29143

Publication type: original article

Language: English

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The Role of Transarterial Embolization in the Treatment of Renal Tumors

Maciej Guziński1,A,B,C,D,E,F, Jacek Kurcz1,D,E,F, Krzysztof Tupikowski2,A,E,F, Ewelina Antosz3,B,C, Paulina Słowik3,B,C, Jerzy Garcarek1,A,E,F

1 Department of General and Interventional Radiology and Neuroradiology, Chair of Radiology, Wroclaw Medical University, Poland

2 Department of Urology and Oncological Urology, Wroclaw Medical University, Poland

Abstract

Background. Renal arterial embolization (RAE) is one of the adjunctive methods in the treatment of renal tumors. Embolization is performed in patients prior to nephrectomy, in patients with inoperable renal tumors as palliative treatment.
Objectives. The purpose of the study was to present and to analyze our own experiences in the embolization of renal tumors.
Material and Methods. A retrospective analysis of 33 patients treated using RAE between 2011 and 2013 was carried out. In 30 cases (91%), embolization was performed due to renal carcinoma and in 3 cases (9%) due to angiomyolipoma. In 11 patients intervention was performed as a palliative procedure because of advanced disease. Histoacrylic glue, polyvinyl alcohol, sponge pledgets and embolization coils were used for embolization.
Results. In 20 patients (61%), selective RAE was performed, whereas superselective RAE was carried out in 13 patients (39%). The technical success rate of RAE was 100%. In one case the procedure was complicated by reflux of the histoacrylic glue into the common femoral artery with its embolization that required surgical embolectomy. We used histoacrylic glue in 26 embolizations (79%), in 19 procedures (58%) as the only embolization agent. Polyvinyl alcohol was used in 10 procedures (30%), gelatin sponge pledgets and absolute ethanol in 6 patients (18%). In 4 cases (12%), coils were implemented. In 22 patients (67%), one or more components of postembolization syndrome (PES) developed. In all 22 patients with PES (100%), severe lumbar pain was observed and administration of analgesics proved necessary. In 10 patients treated by palliative embolization, both a regression of macrohaematuria and an increase in hemoglobin level were observed. In 10 further patients, the creatinine level decreased following RAE.
Conclusion. RAE is an effective and minimally-invasive intervention burdened with low risk of major complications. PES occurs in about two-third of patients. In the majority of patients after palliative embolization, haematuria decreases and the quality of life improves.

Key words

kidney neoplasms, embolization, endovascular procedures, cyanoacrylate glue, coils

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