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EMBOLIZATION OF Kidney ANGIOMYOLIPOMAS indication and INTEREST

H. EL MORABIT, N. EL YOUSFI, S. BOUKLATA. Medical emergency imagery IBN SINA Hospital. EMBOLIZATION OF Kidney ANGIOMYOLIPOMAS indication and INTEREST . INTERVENTIONAL : INTV1. INTV1. INTRODUCTION. Angiomyolipoma (AML) = benign tumor

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EMBOLIZATION OF Kidney ANGIOMYOLIPOMAS indication and INTEREST

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  1. H. EL MORABIT, N. EL YOUSFI, S. BOUKLATA. Medical emergency imagery IBN SINA Hospital. EMBOLIZATION OF Kidney ANGIOMYOLIPOMAS indication and INTEREST INTERVENTIONAL : INTV1 INTV1

  2. INTRODUCTION • Angiomyolipoma (AML) = benigntumor • bleedingrisk =>into life-threatening patient • Support hemorrhagic’s AML = first embolization for hemostasis • AML asymptomatic or minimally symptomatic= discussion topic : • Diameter< 4 cm : surveillance • Diameter> 4 cm : preventive embolization instead of surgery (increasedrisk of bleeding).

  3. MATERIALS AND METHODS • 03 patients : 01 men et 02 women • Meanage = 30 years. • Helical CT without and after injection • MRI. • The materials used for embolization : • Nonabsorbable particles Embosphère calibrated in two patients • " metal Spires" in third patient • After global and selective arteriography scanned

  4. RESULTS • efficient Embolization  immediately in the group treated with Embosphère (judged on biological data, hemodynamic and radiological controls on post-embolization). • Recovery in patient treated / spires.

  5. DISCUSSION

  6. The AML  kidney  = tumor made ​​of varying proportions of : • Adipose tissue, • Smooth muscle cells, • Abnormalvessels. • Classified as "tumor lesion" from perivascularepithelioid cells (PECOME) • Found in two clinical situations: • 80% sporadic (unilateral female predominance) • 20% congenital (bilateral, affecting both sexes)

  7. Tumor↑ volume gradually=> risk of hemorrhagic rupture • This bleeding risk depends on : • Size, • Multifocality, • Presence of intra lesional aneurysms and their size

  8. ↑  KIDNEY EMBOLIZATION : • Purpose   vascular obstruction / of the catheters or various materials with the respect of parenchyma, • Localized or diffuse, temporary or permanent, • ↑frequency in the treatment of AML for three main reasons: • Benign tumor, • Symptoms often due to hemorrhage • Embolization can preserve the healthy renal parenchyma

  9. Catheters use=> hyperselectiveembolizationinteresting the feeder arterial branches of the tumor => ↓ risk of ischemic of the healthyparenchyma • Place of hemostasisembolization +++ in initial management of acute hemorrhagic AML => bleeding stops + not use nephrectomyhemostasis. • Reduction in size after the AML embolization = classic

  10. The success embolization Criteria : • ↓the AML size • ↓vascular component, on acquisitions in scaner or MRI after injection of contrast product, • Absence of occurrence of bleeding episode after a prolonged clinical follow-up.

  11. The post-embolic complications: • related to the procedure intervention itself and the catheterization maneuvers, • related to the consequences of ischemia tumor

  12. CONCLUSION • HemostasisEmbolization  =  method to manage the  emergency hemorrhagic AML . • Préventive Embolization alternative to surgery in the treatment of AML > 4 cm, symptomatic or not, or preparation for surgery • Supportcloses coordination between urologists  and radiologists.

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