Korean J Radiol.  2000 Sep;1(3):121-126. 10.3348/kjr.2000.1.3.121.

Renal Artery Embolization Using a New Liquid Embolic Material Obtained by Partial Hydrolysis of Polyvinyl Acetate (Embol):Initial Experience in Six Patients

• Park SI
• Lee DY
• Won JY
• Park SS

• KMID: 877071
• DOI: http://doi.org/10.3348/kjr.2000.1.3.121

Abstract

OBJECTIVE
To evaluate the therapeutic efficacy of a new liquid embolic materi-al,Embol, in embolization of the renal artery. MATERIALS AND METHODS: Embol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed. RESULTS: The six patients showed immediate total occlusion of their renal vas-cular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hyperten-sion. CONCLUSION: Embol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.

Keyword

Arteries, therapeutic blockade; Embolism, therapeutic; Kidney, interventional procedure; Interventional procedures,technology

MeSH Terms

Aged
Aneurysm, False/therapy
Angiomyolipoma/therapy
Carcinoma, Renal Cell/therapy
Child
*Embolization, Therapeutic
Ethanol
Female
Human
Iohexol/*analogs & derivatives
Kidney Neoplasms/*therapy
Male
Middle Age
Polyvinyls/therapeutic use
*Renal Artery

Figure

• 

  Fig. 1 A 46-year-old female with renal cell carcinoma. A. CT scan of the kidneys shows a huge heterogeneous mass replacing almost the entire right kidney, with thrombosis of the renal vein and inferior vena cava. B. After balloon occlusion, 10 mL of Embol was injected into the proximal right renal artery. Stainless steel coil embolization was also performed. C. Post-embolization aortogram reveals occlusion of the right renal artery.

• 

  Fig. 2 A 66-year-old male with angiomyolipoma. A. CT scan shows a huge fatty mass, 7.5 cm in diameter, at the inferior pole of the right kidney. B. Selective renal angiogram shows a hypervascular mass supplied from the inferior segmental branch of the right kidney. Using a Cobra catheter, 2.5 mL of Embol was injected. C. Near-total occlusion of renal arterial branches supplying the angiomyolipoma is seen.

• 

  Fig. 3 An 11-year-old male with pseudoaneurysm of the renal artery after renal biopsy. A. CT scan shows retroperitoneal hematoma with anteriorly displaced left kidney. B. Selective renal angiogram shows pseudoaneurysm of the inferior segmental branch of the left kidney, about 1 cm in size. Stenosis of approximately 45% at the proximal side of the inferior segmental branch, with post-stenotic dilatation, is also seen. C. Under sonographic guidance, the pseudoaneurysm was directly punctured with a 22-gauge biopsy needle. Five mL of Embol was injected. D. The pseudoaneurysm was occluded.

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