scholarly journals Single-institution retrospective review of elective and emergency embolization of renal angiomyolipoma

2021 ◽  
Vol 15 (11) ◽  
Author(s):  
David Chapman ◽  
Matt Tyson ◽  
Brendan Buckley
Keyword(s):  
Laboratory Data ◽  
Transcatheter Embolization ◽  
Renal Angiomyolipoma ◽  
Clinical Notes ◽  
Post Procedure ◽  
Tertiary Center ◽  
Median Volume ◽  
Median Diameter ◽  
Magnetic Resonance Imaging Mri

Introduction: We aimed to evaluate the size reduction and complications after transcatheter embolization of renal angiomyolipomas (AMLs). Methods: Cases from a single tertiary center were analyzed retrospectively. A blinded radiologist provided measurements of AMLs using a combination of ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Electronic clinical notes, radiographic imaging, and laboratory data were reviewed. Results: Twenty-one embolization procedures from 2002–2019 were analyzed. Four cases were emergency, the remainder elective. The average followup time after intervention was 42 months. Techniques included ethanol, PVA, Gelfoam, Embospheres®, Histacryl®, and coils. The median diameter size of AMLs was 8.6 cm pre-procedure and 6.0 cm post-procedure. The median volume of AMLs was 200 cc pre-procedure and 67 cc post-procedure, with a median reduction in volume of 55%. One case (4.8%) had a re-embolization and three cases (14.3%) proceeded with surgical management of the AML. No cases re-presented with bleeding. Post-embolization syndrome is common. Renal arterial dissection and renal abscess are infrequent complications (9% and 4.5%, respectively). There was no treatment-based mortality. Conclusions: Embolization for renal AMLs is an established, safe, and effective method of treatment and our series further supports that. Determining when to intervene and how long to follow up patients is an issue that has not been well-described; more research needs to be done in this area.

scholarly journals Selective Arterial Embolization of Renal Angiomyolipomas with a N-Butyl Cyanoacrylate-Lipiodol Mixture: Efficacy, Safety, Short- and Mid-Term Outcomes

2021 ◽  
Vol 10 (18) ◽  
pp. 4062
Author(s):  
François-Victor Prigent ◽  
Kévin Guillen ◽  
Pierre-Olivier Comby ◽  
Julie Pellegrinelli ◽  
Nicolas Falvo ◽  
...  
Keyword(s):  
Arterial Embolization ◽  
Volume Reduction ◽  
Renal Angiomyolipoma ◽  
Cyanoacrylate Glue ◽  
Selective Arterial Embolization ◽  
Before And After ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Postembolization Syndrome

Selective arterial embolization (SAE) for renal angiomyolipoma (rAML) is effective to treat or prevent bleeding. We report our experience using a cyanoacrylate–Lipiodol mixture. We performed a single-center retrospective review of all rAMLs embolized with cyanoacrylate glue between July 2014 and June 2020. Demographics, tuberous sclerosis complex (TSC) status, clinical presentation, angiography features, and follow-up data were recorded. Pre- and post-procedure rAML sizes and volumes were estimated from computed tomography (CT) or magnetic resonance imaging (MRI) studies. Kidney function was assessed before and after the procedure. We identified 24 patients (22 females and 2 males, mean age 51 years) treated for 27 AMLs, either prophylactically (n = 20) or as an emergency (n = 4). Technical success was achieved for 25/27 AMLs; two patients, each with a single AML, required nephrectomy and repeated embolization, respectively. Major complications occurred in three patients and minor complications such as postembolization syndrome in 15 patients. AML volume reduction after embolization was 55.1% after a mean follow-up of 15 months (range, 1–72 months). Factors associated with greater volume reduction were a smaller percentage of fat (p = 0.001), larger initial rAML volume (p = 0.014), and longer follow-up (p = 0.0001). The mean creatinine level did not change after SAE. Embolization of rAMLs with a mixture of cyanoacrylate and Lipiodol is feasible, safe, and effective in significantly decreasing tumor volume.

Borderline positive antineutrophil cytoplasmic antibodies (ANCA)-PR3/MPO detection in a large cohort tertiary center: lessons learnt from a real-life experience

2018 ◽  
Vol 56 (6) ◽  
pp. 947-953 ◽  
Author(s):  
Abdulla Watad ◽  
Nicola L. Bragazzi ◽  
Kassem Sharif ◽  
Boris Gilburd ◽  
Yarden Yavne ◽  
...  
Keyword(s):  
Life Experience ◽  
Laboratory Data ◽  
Real Life ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Enzyme Linked Immunosorbent Assay ◽  
Female Ratio ◽  
Tertiary Center ◽  
Male To Female ◽  
Antibody Tests

Abstract Background: Enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF) are the best strategies for antineutrophil cytoplasmic antibodies (ANCA) detection. In a minority of subjects, ELISA-based ANCA testing may result in a borderline positive titre. Therefore, we assessed the clinical significance of such a result. Methods: This is a retrospective study, which included all subjects screened for ANCA subtypes (myeloperoxidase (MPO) or proteinase-3 (PR3)) with subsequent identification of borderline positive results, as determined by ELISA and retested using IIF. The demographic, clinical and laboratory data of subjects with borderline positive ANCA test results were extracted from their medical records. Results: A total of 14,555 PR3/MPO-ANCA tests were performed with ELISA during the study period (2006–2016). Of the 14,555 PR3-ANCA antibody tests that were performed, 94 were borderline positive (titre 0.9–1.1), and of 14,555 MPO-ANCA antibody tests, 43 were borderline positive (titre 0.9–1.1). The male-to-female ratio was 1:1.08 and the mean age was 50.95±21.79 years. Four MPO-ANCA (9.30%) and 11 PR3-ANCA (11.70%) antibody borderline samples resulted positive on IIF testing. Subjects with borderline positive MPO-ANCA were found to have a poorer outcome in terms of renal failure and the requirement of dialysis. Conclusions: Subjects with borderline positive MPO-ANCA and positive p-ANCA (IIF) seem to have a less favorable outcome. Physicians should be aware of these findings and possibly perform a closer follow-up and routine screening for these subjects.

scholarly journals Renal angiomyolipoma

2019 ◽  
Vol 65 (7) ◽  
pp. 977-981 ◽  
Author(s):  
Selahattin Çalışkan ◽  
Gülistan Gümrükçü ◽  
Emrah Özsoy ◽  
Ramazan Topaktas ◽  
Metin İshak Öztürk
Keyword(s):  
Laboratory Data ◽  
Renal Tumors ◽  
Pathological Examination ◽  
Renal Angiomyolipoma ◽  
Epithelioid Angiomyolipoma ◽  
Study Results ◽  
The Mean ◽  
Pathology Reports ◽  
Laparoscopic Techniques

SUMMARY INTRODUCTION Angiomyolipoma is one of the most common benign solid renal tumors. We investigated the characteristics of renal angiomyolipomas and the clinical outcomes of patients in the last thirteen years. METHODS The medical records of the patients who underwent nephrectomy were reviewed retrospectively from July 2005 to May 2018. The laboratory data, radiology, and pathology reports were recorded. Patients diagnosed with angiomyolipoma were included in the study. RESULTS A total of 28 patients were included in the study, eight of them male. The mean age of the patients was 55.89+14.49 years. The patients were treated with open and laparoscopic techniques. Partial nephrectomy was performed in 12 patients(42.85%). After pathological examination, 23 patients were diagnosed as fat rich, four patients as fat poor, and one as epithelioid angiomyolipoma. There were no recurrences in the follow-up 91.21+48.31 months. CONCLUSION Angiomyolipoma is a rare renal tumor in daily urology practice. Clinicians must be aware of its complications and manage patients well.

Renal Angiomyolipoma: Superselective Arterial Embolization and Long Term Follow-up

1997 ◽  
Vol 37 (1) ◽  
pp. 71
Author(s):  
Young Hwan Lee ◽  
Young Min Han ◽  
Chong Soo Kim ◽  
Gyung Ho Chung ◽  
Sang Yong Lee ◽  
...  
Keyword(s):  
Arterial Embolization ◽  
Renal Angiomyolipoma ◽  
Long Term Follow Up

Medullary thyroid cancer follow-up in a tertiary center

2020 ◽  
Author(s):  
Tugce Apaydin ◽  
Eren Imre ◽  
Yavuz Dilek Gogas
Keyword(s):  
Thyroid Cancer ◽  
Medullary Thyroid Cancer ◽  
Medullary Thyroid ◽  
Tertiary Center

Assessment of Duodenal Diverticula: Computed Tomography Findings

2019 ◽  
Vol 15 (10) ◽  
pp. 948-955
Author(s):  
Erdem Yilmaz ◽  
Osman Kostek ◽  
Savas Hereklioglu ◽  
Muhammet Goktas ◽  
Nermin Tuncbilek
Keyword(s):  
Computed Tomography ◽  
Contrast Agent ◽  
Ampulla Of Vater ◽  
Common Type ◽  
Radiological Features ◽  
New Findings ◽  
Duodenal Diverticula ◽  
Median Diameter ◽  
Colonic Diverticula

Aims: To demonstrate the prevalence, accompanying pathologies, imaging and follow up findings of Duodenal Diverticula (DD) with Multidetector Computed Tomography (MDCT). Materials and Methods: Consecutive 2910 abdominal MDCTs were retrospectively reviewed on axial, coronal and sagittal planes. DD were evaluated for prevalence, location, number, size, contents, diverticular neck, accompanying pancreaticobiliary pathologies, jejunal and colonic diverticula, respectively. Results: DD were diagnosed in 157 cases (5.4%) and found mostly in the second part of the duodenum. Juxta-ampullary DD was the most common type (78.3%) and mostly located ventral (n:86, 69.9%) to the ampulla of Vater. DD was solitary in 123 patients (78.3%) and more than one in 34 patients (21.7%). The median diameter of DD was 2.5 cm (range 1.5-3.6 cm) in the long-axis. The lumen of DD contains air and contrast agent (n:96, 61.1%); air, contrast agent and debris (n:42, 26.7%) in most cases. Colonic diverticula (n:36, 22.9%), cholelithiasis (n:32, 20.4%), choledocholithiasis (n:7, 4.4%), and biliary dilatation (n:8, 5.1%) were the most common additional findings. Median follow-up time was 23 months (range 11 to 41 months). In three cases, new findings (cholelithiasis, n:3, choledocholithiasis, n:1) were detected. Conclusion: Accompanying pathologies with DD diagnosis are valuable for physicians in order to manage the patients. Following clinical and radiological features of well-diagnosed DD might reduce the possible complications.

Desmoid tumour of the distal forearm involving the distal radioulnar joint

2020 ◽  
Vol 13 (11) ◽  
pp. e237097
Author(s):  
Apoorv Sehgal ◽  
Pratyush Shahi ◽  
Avijeet Prasad ◽  
Manoj Bhagirathi Mallikarjunaswamy
Keyword(s):  
Distal Radioulnar Joint ◽  
Treatment Modalities ◽  
Desmoid Tumour ◽  
X Rays ◽  
Distal Forearm ◽  
Left Wrist ◽  
Radioulnar Joint ◽  
Magnetic Resonance Imaging Mri ◽  
Epidemiology Investigation

A 32-year-old woman presented with progressive pain and swelling of the left wrist for 6 months. Physical examination revealed a firm, tender, oval swelling over the left wrist. X-rays showed a pressure effect on the distal radius and ulna. Magnetic Resonance Imaging (MRI) revealed a well-defined, asymmetrical, dumbbell-shaped soft-tissue lesion involving the interosseous region of the distal forearm and extending until the distal radioulnar joint (DRUJ). Core needle biopsy confirmed the diagnosis of desmoid tumour. Marginal excision of the tumour was done. At the 2-year follow-up, the patient was doing well and had painless and improved left wrist motion. Desmoid tumour involving the DRUJ has not been previously reported. We, through this case, report new observation and discuss the epidemiology, investigation of choice, treatment modalities, and the need for a regular follow-up for appendicular desmoid tumours.

Neuroimaging of Children With Takayasu Arteritis

2021 ◽  
pp. 088307382199128
Author(s):  
Hafize Emine Sönmez ◽  
Ferhat Demir ◽  
Semanur Özdel ◽  
Şerife Gül Karadağ ◽  
Esra Bağlan ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Internal Carotid ◽  
Laboratory Data ◽  
Left Middle Cerebral Artery ◽  
Mri Findings ◽  
Cranial Mri ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
And Diffusion ◽  
Left Middle

Objective: Takayasu arteritis is a rare granulomatous chronic vasculitis that affects the aorta and its main branches. Neurologic manifestations can accompany the disease; however, there is no study on neuroimaging in children with Takayasu arteritis. Therefore, we aimed to evaluate cranial magnetic resonance imaging (MRI) in pediatric Takayasu arteritis patients. Materials and Methods: Demographic, clinical, and laboratory data were obtained retrospectively. Results: The study included 15 pediatric Takayasu arteritis patients. All patients presented with constitutional symptoms. Additionally, 6 patients suffered from headache, 2 had syncope, 1 had loss of consciousness, and 1 had convulsion. All patients underwent cranial and diffusion MRI a median 12 months after diagnosis. Cranial MRI findings were normal in 12 patients, whereas 3 patients had abnormal findings, as follows: stenosis in the M1 and M2 segments of the left middle cerebral artery (n = 1); diffuse thinning of the right internal carotid, middle cerebral, and right vertebral and basilar artery (n = 1); as a sequela, areas of focal gliosis in both the lateral ventricular and posterior periventricular regions (n = 1). Among these 3 patients, 1 had no neurologic complaints. Conclusion: Abnormal MRI findings can be observed in pediatric Takayasu arteritis patients, even those that are asymptomatic; therefore, clinicians should carefully evaluate neurologic involvement in all pediatric Takayasu arteritis patients.

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