The efficacy and outcomes of urgent superselective transcatheter arterial embolization of patients with ruptured renal angiomyolipomas

BACKGROUND: To assess the efficacy and outcomes of urgent superselective transcatheter arterial embolization for emergency patients with ruptured renal angiomyolipomas. METHODS: During a 49-month period, all emergency patients with ruptured angiomyolipomas that underwent urgent superselective transcatheter arterial embolization within the first 24 hours of admission were enrolled in this study. In each case, clinical presentation, trauma history, success or failure of embolization, presence of postembolization syndrome, and the necessity of subsequent emergency surgery of nephron-sparing surgery, and partial or total nephrectomy were recorded and analyzed. RESULTS: The sample population consisted of seven female patients with ruptured angiomyolipomas; mean age was 48 years. The initial presenting symptoms were flank pain (n = 7), hematuria (n = 5), and lower hematocrit (Hb <10; n = 7). All individuals had received blood transfusion before the embolization. Two were traffic crash victims admitted in shock. Successful embolization was achieved in all cases; however, postembolization syndrome was noted in four. There was no requirement for emergent surgery after embolization. CONCLUSIONS: Urgent superselective transcatheter arterial embolization was an effective treatment for our sample of emergency patients with ruptured renal angiomyolipomas where conservative supportive treatments had failed. There was no need of emergency surgery after embolization.