Angiomyolipoma embolization
What is angiomyolipoma embolization?
What is angiomyolipoma?
An angiomyolipoma is a rare benign tumor that grows in the kidney. The tumor is made up of a combination of three types of tissue: blood vessels, muscle cells and fat cells. This unusual combination is what gives angiomyolipomas their specific characteristics.
Even though they are usually non-cancerous, angiomyolipomas should not be ignored. One reason for this is their potential for causing complications, typically due to their size or tendency to bleed. As an angiomyolipoma grows, it can exert pressure on neighboring tissues, causing symptoms such as back pain, abdominal discomfort and internal bleeding. In some cases, excess growth of the tumor can also impact kidney function.
How is embolization used to treat angiomyolipoma?
Angiomyolipoma embolization is an innovative interventional radiology technique designed to treat this type of kidney tumor without using invasive surgery. Its main purpose is to reduce the flow of blood to the tumor by using special materials that block the relevant blood vessels.
This approach offers several significant advantages. First, embolization is performed on an outpatient basis, meaning the patient does not require an extended hospital stay. Second, it is a non-invasive method; the risks typically associated with open surgery are therefore considerably reduced. By blocking the supply of blood to the tumor, embolization causes it to shrink over time. This helps relieve symptoms resulting from the pressure on nearby tissues while also lowering the risk of internal bleeding.
What happens during angiomyolipoma embolization at the American Hospital of Paris?
Angiomyolipoma embolization is a minimally invasive procedure performed in the outpatient department of the American Hospital of Paris. It is completely pain-free and does not leave a scar.
Procedure
The procedure is performed by one of our interventional radiologists specialized in the field. Before the procedure, a local anesthesia will be administered to ensure you remain comfortable throughout the operation.
Under image guidance, the radiologist inserts a thin catheter into the appropriate artery, generally through the groin. This minimally invasive approach eliminates the need for large incisions and considerably reduces the risks associated with traditional surgery.
Tiny particles (often microspheres) are inserted through the catheter into the blood vessels that supply the angiomyolipoma. These particles block the vessels, thus reducing the tumor’s blood supply. This gradual reduction in blood flow causes the tumor to shrink and as a result, become less active.
Procedure duration
The angiomyolipoma embolization procedure is relatively brief, lasting around one hour on average.
Post-operative follow-up
After the embolization, it is normal to feel a little discomfort or light pain in the lumbar (lower back) area. A prescription for the appropriate medication will be given to you. You will be allowed go home after a short period of observation to monitor your recovery. Our team will be available via a 24/7 hotline to answer any questions you may have.
Cost and coverage
The cost of angiomyolipoma embolization is covered by Assurance Maladie, the French national health insurance, and by supplementary private insurers. However, additional physician and/or hospitalization fees may apply.
What are the outcomes of angiomyolipoma embolization?
Recent studies show that angiomyolipoma embolization is effective in reducing tumor size and attenuating symptoms. Patients often report significant relief of symptoms after the procedure. We use the most efficient technique, which reduces tumor size by more than 50% and lowers the risk of bleeding.
A 2008 study analyzed the results of elective and emergency renal angiomyolipoma embolization in 17 patients (who underwent 23 embolizations) (1). The results showed the procedure’s long-term efficacy and lasting outcomes.
Another study conducted in 2013 on 13 patients (16 embolization procedures) analyzed the reduction in angiomyolipoma size following the procedure (2). The results showed an average angiomyolipoma size reduction of up to 25.6% at 12 months, 27.5% at 24 months, 35% at 36 months and 36.8% at 48 months after the embolization.
A 2017 study also focusing on selective embolization of renal angiomyolipoma showed its efficacy and safety in reducing tumor size (3). The study involved 23 patients (34 angiomyolipomas), with a technical success rate of 96%. Complications were rare, while mean tumor size reduction was 26.2% at 20 months.
A 2021 study involving 24 patients (27 renal angiomyolipomas) evaluated the outcomes and safety of angiomyolipoma embolization performed with a cyanoacrylate-lipiodol mixture (4). Results showed an angiomyolipoma volume reduction of 55.1% following a mean follow-up of 15 months. Major complications were rare, and kidney function was not impacted by the embolization.
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What are the possible side effects of angiomyolipoma embolization?
Angiomyolipoma embolization is a minimally invasive procedure that is generally safe. The risks of complications are rare:
- Bleeding at the catheter insertion site or inside the kidney
- Risk of infection associated with catheter insertion
- Allergic reaction to the contrast dye used during the procedure
- Risk of kidney lesions
- Post-embolization syndrome, with temporary, flu-like symptoms
- Possible risk of angiomyolipoma recurrence
It should be noted that these side effects are generally minor and easily managed. Your medical team will provide detailed information prior to your procedure.
Angiomyolipoma embolization: Key figures
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> 4cm
Minimum size required for embolization or ablation surgery.
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80%
Percentage of sporadic and isolated angiomyolipomas. The remaining 20% develop in combination with tuberous sclerosis (Bourneville disease) or pulmonary lymphangioleiomyomatosis..
