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TRANSARTERIAL EMBOLIZATION AND ABLATION OF RENAL ARTERIOVENOUS MALFORMATIONS: EFFICACY AND DAMAGES IN 30 PATIENTS WITH LONG-TERM FOLLOWUP

1998; Lippincott Williams & Wilkins; Volume: 159; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(01)63703-0

1527-3792

Shigeo Takebayashi, Masahiko Hosaka, Yoshinobu Kubota, Eiichi Ishizuka, Akira Iwasaki, Sho Matsubara,

Abdominal vascular conditions and treatments

No AccessJournal of UrologyClinical Urology: Original Articles1 Mar 1998TRANSARTERIAL EMBOLIZATION AND ABLATION OF RENAL ARTERIOVENOUS MALFORMATIONS: EFFICACY AND DAMAGES IN 30 PATIENTS WITH LONG-TERM FOLLOWUP SHIGEO TAKEBAYASHI, MASAHIKO HOSAKA, YOSHINOBU KUBOTA, EIICHI ISHIZUKA, AKIRA IWASAKI, and SHO MATSUBARA SHIGEO TAKEBAYASHISHIGEO TAKEBAYASHI , MASAHIKO HOSAKAMASAHIKO HOSAKA , YOSHINOBU KUBOTAYOSHINOBU KUBOTA , EIICHI ISHIZUKAEIICHI ISHIZUKA , AKIRA IWASAKIAKIRA IWASAKI , and SHO MATSUBARASHO MATSUBARA View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63703-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the long-term efficacy and side effects of transarterial embolization and ablation for renal arteriovenous malformations. Materials and Methods: A total of 30 patients with cirsoid arteriovenous malformations causing massive hematuria underwent 34 procedures of embolization or ablation. We confirmed the ratios of occluded arteriovenous malformation areas on angiograms and those of infarcted areas on computerized tomography. All patients were followed for 4.1 to 15.0 years (mean 8.0 +/− 2.8) after the initial procedures. Results: Hematuria ceased in all patients after the initial procedures, including partial embolization or ablation of the arteriovenous malformations in 8. Massive hematuria recurred in 4 patients, who had undergone absorbable gelatin sponge (2), embolization, combined alcohol and subselective absorbable gelatin sponge embolization (1) and polyvinyl alcohol particles embolization (1). In these 4 cases total ablation of the arteriovenous malformations with alcohol was successful. In 29 patients, including aforementioned 4, no hematuria recurred after 5 years following total or partial ablation with alcohol. Large nontarget embolization with reflux of subselectively infused absorbable gelatin sponge caused a nonfunctioning kidney in 1 patient. The remaining 33 procedures caused 6.3 to 48.0% (mean 15.7 +/− 6.9%) areas of renal infarction. Polyvinyl alcohol embolization caused pulmonary embolism and renin dependent hypertension. Conclusions: Partial or total transarterial ablation of arteriovenous malformations with alcohol proved effective for long-term cessation of hematuria. However, this procedure as well as transarterial embolization has the potential risk of nontarget infarction. References 1 : Embolization of benign lesions of the urinary tract. In: Clinical Urography.. Edited by . Philadelphia: W. B. Saunders Co.1990: 2997. Google Scholar 2 : Renal arteriovenous malformations masquerading as renal cell carcinoma. Urology1995; 46: 716. Google Scholar 3 : Renal arteriovenous malformations: transcatheter embolization and follow-up. AJR1981; 137: 113. Google Scholar 4 : Symptomatic vascular malformations: ethanol embolotherapy. Radiology1989; 170: 1059. Google Scholar 5 : Arterovenous malformations of the kidneys: ablation with alcohol. AJR1988; 150: 587. Google Scholar 6 : Renal arteriovenous malformations: transcatheter embolization with epinephrine enhanced technique. Jap. J. Clin. Rad.1984; 29: 15. Google Scholar 7 : Embolotherapy: agents, clinical applications, and techniques. RadioGraphics1994; 14: 623. Google Scholar 8 : Therapeutic embolization with long-term occluding agents and their effects on embolized tissues. Radiology1977; 125: 677. Google Scholar 9 : Histologic long-term follow-up after embolization with polyvinyl alcohol particles. Amer. J. Neurorad.1995; 16: 843. Google Scholar 10 : Total or partial percutaneous renal ablation in the treatment of renovascular hypertension: radiological and clinical aspects. Brit. J. Rad.1989; 62: 593. Google Scholar 11 : Early mechanism of action of arterially infused alcohol USP in renal devitalization. Radiology1982; 145: 45. Google Scholar 12 : Hepatic artery embolization of experimental hepatic tumors with absolute ethanol. Cardiovasc. Intervent. Rad.1986; 9: 146. Google Scholar 13 : Metrizamide-ethanol for treatment of symptomatic vascular malformations. Amer. J. Hosp. Pharm.1994; 51: 2969. Google Scholar 14 : Renal ablation with absolute ethanol. Mechanism of action. Invest. Rad.1984; 19: 416. Google Scholar From the Departments of Radiology and Urology, Yokohama City University School of Medicine, and Yokohama Red Cross Hospital, Yokohama, Japan.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 159Issue 3March 1998Page: 696-701 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information SHIGEO TAKEBAYASHI More articles by this author MASAHIKO HOSAKA More articles by this author YOSHINOBU KUBOTA More articles by this author EIICHI ISHIZUKA More articles by this author AKIRA IWASAKI More articles by this author SHO MATSUBARA More articles by this author Expand All Advertisement PDF downloadLoading ...