Embolotherapy with a Mixture of Lipiodol and Ethanol for Renal Angiomyolipoma: Retrospective Study

WK Tso, S Wong, J Tsang, H Tung, KS Tai, PC Tam, L Leong

Hong Kong J Radiol 2005;8:78-82

Objective: To evaluate the efficacy of embolotherapy with a mixture of lipiodol and absolute ethanol for renal angiomyolipoma.

Patients and Methods: Twelve patients underwent transcatheter embolisation for 13 symptomatic renal angiomyolipomas between November 1997 and May 2005. Of these, 2 patients had tuberous sclerosis with bilateral renal angiomylipomas. The diagnoses of renal angiomyolipoma were made on the basis of the characteristic computed tomographic findings. The angiomyolipomas were embolised with a 1:3 mixture of lipiodol and absolute ethanol (range, 3 to 10 ml; mean, 4.9 ml). Patients were followed up for 2 months to 7 years. The efficacy of embolotherapy was evaluated in terms of immediate and late complications, symptom-free period, tumour size, and imaging findings.

Results: There was no procedure-related complication and no embolisation-related mortality. During the follow-up period, 9 of the 13 tumours (69%) decreased in size, whereas 3 (23%) of the tumours increased in size. Five of the 12 patients (42%) showed no symptom of recurrence during follow-up. The mean symptom-free period was 35 months. Eleven of the 12 tumours (92%) among the surviving patients showed no evidence of rupture after embolotherapy. One patient required a second embolisation, 1 patient underwent an open nephrectomy 4 years later, and 1 patient subsequently underwent a laparoscopic partial nephrectomy.

Conclusion: Transarterial embolisation with a 1:3 mixture of lipiodol and absolute ethanol is an effective and safe method of treating renal angiomyolipoma; it results in tumour shrinkage and prevention of tumour rupture.