Angiomyolipoma surgery: Difference between revisions

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Revision as of 17:02, 5 October 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [3]

Overview

Surgery is not the first-line treatment option for patients with angiomyolipoma. Transcatheter arterial embolization is usually reserved for patients with complicated disease.^[1]

Surgery

Angiomyolipoma do not normally require surgery unless there is life-threatening bleeding.

Transcatheter Arterial Embolization

Proximal Embolization
- These are appropriate for the occlusion of a large lumen without distal migration
Distal Embolization
- These are appropriate for the occlusion of a large lumen with distal migration
Palliative Embolization
- Embolization in patients with end-stage renal disease

A
B
C
D

Figures A-D: Angiographic runs showed a significantly ptosed right kidney, with supply to the large upper pole angiomyolipoma via tortuous artery arising from the superior division of the right renal artery.^[2]

Embolization Procedure

Selective catheterization of the branch supplying the angiomyolipoma is achieved via microcatheter
Contrast is infused
Embolization is usually performed using a 50:50 dilution of absolute alcohol in lipiodol
A total of 12 mL is injected under careful angiographic observation to ensure no reflux to vessels supplying renal cortex

Partial Nephrectomy

Larger angiomyolipomas, that have been symptomatic, can be electively resected with a partial nephrectomy.^[3]

References

↑ Lewis JH, Weingold AB (1985). "The use of gastrointestinal drugs during pregnancy and lactation". Am J Gastroenterol. 80 (11): 912–23. PMID 2864852.
↑ Image courtesy of Dr. Andrew Lawson. Radiopaedia(original file [1]). Creative Commons BY-SA-NC
↑ Treatment and Prognosis. http://radiopaedia.org/articles/renal-angiomyolipoma

Template:WikiDoc Sources

[pmid2864852-1] Lewis JH, Weingold AB (1985). "The use of gastrointestinal drugs during pregnancy and lactation". Am J Gastroenterol. 80 (11): 912–23. PMID 2864852.

[radio-2] Image courtesy of Dr. Andrew Lawson. Radiopaedia(original file [1]). Creative Commons BY-SA-NC

[3] Treatment and Prognosis. http://radiopaedia.org/articles/renal-angiomyolipoma

[1]

[2]

[3]

@@ Line 14: / Line 14: @@
 *Palliative Embolization
 **Embolization in patients with [[end-stage renal disease]]
-<gallery mode=packed heights=150px style="text-align:left">
+<gallery widths=200px class="center">
-Renal-angiomyolipoma-8_(1).jpg | <ref name=radio> Image courtesy of Dr. Andrew Lawson. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/renal-angiomyolipoma-8]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
+Renal-angiomyolipoma-8_(1).jpg |A
-Renal-angiomyolipoma-8_(2).jpg | <ref name=radio> Image courtesy of Dr. Andrew Lawson. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/renal-angiomyolipoma-8]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
+Renal-angiomyolipoma-8_(2).jpg |B
-Renal-angiomyolipoma-8_(3).jpg | <ref name=radio> Image courtesy of Dr. Andrew Lawson. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/renal-angiomyolipoma-8]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
+Renal-angiomyolipoma-8_(3).jpg |C
-Renal-angiomyolipoma-8_(4).jpg | <ref name=radio> Image courtesy of Dr. Andrew Lawson. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/renal-angiomyolipoma-8]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
+Renal-angiomyolipoma-8_(4).jpg |D
-Renal-angiomyolipoma-8_(5).jpg | <ref name=radio> Image courtesy of Dr. Andrew Lawson. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/renal-angiomyolipoma-8]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
 </gallery>
+*'''Figures A-D: '''Angiographic runs showed a significantly ptosed right kidney, with supply to the large upper pole angiomyolipoma via tortuous artery arising from the superior division of the right renal artery.<ref name=radio> Image courtesy of Dr. Andrew Lawson. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/renal-angiomyolipoma-8]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
 '''Embolization Procedure'''