Korean J Radiol.  2010 Oct;11(5):574-578. 10.3348/kjr.2010.11.5.574.

Transcatheter Arterial Embolization Using Ethanol in a Dialysis Patient for Contracting Enlarged Polycystic Kidneys

• Rim H
• Jung GS
• Jung YS

• KMID: 1102585
• DOI: http://doi.org/10.3348/kjr.2010.11.5.574

Abstract

The mass effect of nephromegaly in patients with autosomal dominant polycystic kidney disease may cause pain and symptoms by compressing the alimentary tract, lungs, and heart. Conventional therapies exist to contract enlarged polycystic kidneys including surgical and interventional procedures. A surgical nephrectomy is often difficult to perform in dialysis patients due to the associated risks related to surgery. In contrast, renal transcatheter arterial embolization (TAE) with metallic coils, which is a less invasive interventional procedure, can also be utilized to contract enlarged kidneys in dialysis patients as an effective treatment. However, metallic coils present the possibility of recanalization and cost issues. Thus, we used ethanol instead of coils in renal TAE to resolve these issues. We report a dialysis patient with enlarged polycystic kidneys and poor oral intake due to abdominal distention that was successfully treated by TAE with absolute ethanol.

Keyword

Transcatheter arterial embolization; Autosomal dominant polycystic kidney disease; Ethanol

MeSH Terms

Aged
Contrast Media/administration & dosage
Embolization, Therapeutic/*methods
Ethanol/*therapeutic use
Ethiodized Oil/administration & dosage
Humans
Male
Polycystic Kidney, Autosomal Dominant/radiography/*therapy
*Renal Dialysis
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Ethanol embolization in 65-year-old man with polycystic kidneys. A. Right renal arteriogram before transcatheter arterial embolization shows narrowed renal arteries. B. After transcatheter arterial embolization, right renal artery is occluded. C. Renal arteriogram before transcatheter arterial embolization shows greater narrowing of left than right renal artery. D. After transcatheter arterial embolization, left renal artery is occluded. E, F. Changes in CT images before transcatheter arterial embolization and at 18 months after transcatheter arterial embolization show marked decrease in volume of both kidneys. G. Changes in volume of kidneys, and clinical parameters as function of time after transcatheter arterial embolization.

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