KẾT QUẢ BƯỚC ĐẦU ĐIỀU TRỊ U CƠ MỠ MẠCH THẬN BẰNG NÚT MẠCH SỬ DỤNG HỖN HỢP CỒN TUYỆT ĐỐI VÀ LIPIODOL

Abstract

Background: Renal angiomyolipoma (AML) is the most common benign renal tumor and carries a risk of hemorrhage, particularly in lesions with large size or intratumoral aneurysms. Selective arterial embolization (SAE) is a minimally invasive and effective treatment for symptom control and hemorrhage prevention. A mixture of absolute ethanol and lipiodol is considered an effective embolic agent due to its ability to induce tumor necrosis and its excellent radiopacity under DSA guidance. Objective: To evaluate the early outcomes of selective arterial embolization using an absolute ethanol–lipiodol mixture in the treatment of renal angiomyolipoma. Materials and Methods: A longitudinal interventional descriptive study with pre- and post-treatment comparison was conducted on 34 patients with 36 AMLs. Clinical data, imaging findings, procedural details, and outcomes at 1 month and 6 months were analyzed. Treatment efficacy was assessed based on technical success, symptom improvement, and tumor volume reduction. Results: The female-to-male ratio was 16:1, with a mean age of 49 ± 15,3 years. Symptomatic patients accounted for 5,3%. The 1:1 ethanol–lipiodol mixture ratio was used most frequently (41,7%). Technical success was achieved in 97.2% of cases. At 6 months, mean tumor volume decreased by 48,6 ± 13,5% (p < 0.001). Lesions with fat content <50% showed significantly greater volume reduction compared with those ≥50% (p < 0,05). Conclusion: Selective arterial embolization of renal angiomyolipoma using an absolute ethanol–lipiodol mixture provides a high technical success rate, significant tumor volume reduction, and clinical symptom improvement. Early complications included post-embolization syndrome (47,2%) and non-target embolization (11,1%), with no cases of renal failure.