Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.005515
Jornal Vascular Brasileiro
Therapeutic Challenge

Embolização arterial superseletiva para tratamento de angiomiolipoma em paciente com rim único

Superselective arterial embolization for treatment of angiomyolipoma in a patient with a single kidney

Adenauer Marinho de Oliveira Góes Junior; Salim Abdon Haber Jeha; José Rui Couto Salgado

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Resumo

Resumo Os autores relatam o caso de uma paciente jovem previamente submetida a nefrectomia direita por apresentar angiomiolipomas renais (AMLRs) e portadora de dois volumosos angiomiolipomas no rim esquerdo remanescente. A paciente foi encaminhada pelo urologista para tratamento endovascular. Realizou-se embolização superseletiva de um dos tumores, localizado no polo renal inferior e em situação subcapsular; apesar de várias tentativas, não foi obtido um cateterismo seletivo suficiente para embolizar o segundo angiomiolipoma (localizado no polo renal superior) sem que um volume considerável de parênquima renal adjacente sofresse isquemia. O procedimento e a recuperação da paciente transcorreram sem complicações. A paciente recebeu alta no primeiro pós-operatório e vem sendo acompanhada ambulatorialmente há 9 meses sem intercorrências. É feita uma breve revisão sobre indicações, aspectos técnicos e complicações do tratamento endovascular dos AMLRs, além de serem discutidas vantagens dessa técnica quando comparada à ressecção cirúrgica dos tumores.

Palavras-chave

angiomiolipoma, rim, embolização terapêutica

Abstract

Abstract The authors report on a case of a young woman who had previously undergone a right nephrectomy due to renal angiomyolipomas, currently presenting voluminous angiomyolipomas of the remaining kidney. The patient’s urologist referred her for endovascular treatment. Superselective arterial embolization of one tumor (located at the inferior renal pole), was conducted successfully. Several attempts at selective catheterization were made to embolize the second angiomyolipoma (located at the superior lobe), without jeopardizing a significant amount of the surrounding renal parenchyma, but this ultimately proved not to be feasible. The procedure and recovery were uneventful. The patient was discharged on the first postoperative day and has been followed for 9 months with no complications. The authors provide a brief review of the indications, technical aspects and complications of endovascular treatment of renal angiomyolipomas and also discuss the advantages of the endovascular approach over surgical resection for this kind of tumor.

Keywords

angiomyolipomas, kidney, therapeutic embolization

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