Purpose: The decision to electively treat angiomyolipomas (AMLs) has traditionally been based on size. More recently additional factors are also considered, including the presence of abnormal intralesional vessels. A variety of embolic agents have been used to treat AMLs and it is unclear which is most beneficial. At our institution, absolute alcohol is the primary embolic agent. This case series aimed to assess the efficacy and safety of AML embolization with absolute alcohol.
Material and Methods: Alcohol embolization therapy was introduced 6.5 years ago. Over that period and using electronic records, a retrospective review of elective AML embolization was performed.
Results: Twenty-two patients (4 male, 18 female) with a mean age of 49.9 years (range 30.3-81.9) underwent 23 alcohol embolization procedures to treat 24 AMLs during the study period. One patient had 2 AMLs treated and this was done in 2 sittings. Mean baseline AML size was 5.6 cm (3.1-9.4). For the 18 (75%) lesions with imaging follow-up, there was a significant decrease in size following treatment (5.6 to 3.3 cm, p < 0.05) at a mean follow-up of 14.0 months (3.0-43.8). There was no change in serum creatinine (baseline mean 67.3 μmol/L vs. follow-up 72.6 μmol/L, p = 0.14). There were 3 complications (13.0 %), all of which were Clavien-Dindo grade I. There were no recorded bleeds from an AML following treatment.
Conclusions: Elective AML embolization with absolute alcohol significantly decreases tumour size and has no effect on renal function. There were no recorded post-procedural AML bleeds.