Long-term outcomes of selective arterial embolization in giant renal angiomyolipoma: A retrospective single-center study

Objectives: To evaluate the long-term outcomes of selective trans-arterial embolization (SAE) in patients with giant (⩾10 cm in size) renal angiomyolipomas (AMLs) at our tertiary referral center. Patients and methods: This retrospective, single-center study included 44 patients who underwent SAE for AMLs of ⩾10 cm size between July 2018 and June 2024. Collected data included demographics, tumor characteristics, clinical symptoms, type of intervention, tumor size before and after embolization, and renal function. Outcomes assessed were tumor size reduction, preservation of renal function, reintervention rates during follow-up and complications following SAE. Results: The study included 46 tumors in 44 patients. Mean patient age was 40.4 years (range: 23–60), with 86.3% being females. Mean follow-up duration was 25.2 months (range: 6–70 months). Eleven patients (25%) were associated with TSC, and all were offered Everolimus postoperatively. The mean tumor size decreased significantly from 13.2 ± 3.12 cm pre-embolization to 10.3 ± 2.45 cm post-embolization ( p = 0.003). Renal function remained stable during follow-up, with no significant changes in serum creatinine ( p = 0.6) and eGFR ( p = 0.8). The overall success rate was 84.7%, with 13.6% experiencing re-intervention. Complications included post-embolization syndrome (43.1%) and allergic reactions (6.8%), while one patient required nephrectomy due to a perinephric abscess. Conclusion: Selective Trans-arterial Embolization is a safe and effective treatment for giant renal AMLs, resulting in significant tumor size reduction, symptom relief, and preservation of renal function. It offers a minimally invasive alternative to traditional surgical approaches, particularly for patients with high surgical risk or those requiring nephron-sparing procedure.