What is angiomyolipoma (AML) embolization?

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AML embolization is a minimally invasive procedure that doctors use to treat AML.

The procedure involves the insertion of a catheter into the blood vessels that supply the tumor. Using imaging guidance, a doctor can navigate the catheter to the site of the AML. They then inject small particles known as embolic agents through the catheter, blocking the blood flow to the tumor and causing it to shrink.

What is AML in the kidney?

Renal AML is a type of benign (noncancerous) tumor that can develop in the kidneys. Generally, AML is rare, representing 1–3% of solid renal tumors.

While experts do not yet understand the exact cause of AML, in some cases, it has links with a genetic condition called tuberous sclerosis complex (TSC).

Not all cases of AML in the kidneys cause symptoms or require treatment. A doctor may recommend treatment in some situations, such as if the tumor is at risk of rupturing.

Some indications for AML embolization include:

• Size: If an AML measures more than 4 centimeters (cm) in diameter, there is an increased risk of bleeding or rupture. In such cases, embolization can reduce the size of the AML and decrease the risk of complications.
• Symptoms: AMLs can cause pain, discomfort, and bleeding. If an AML causes significant symptoms that affect a person’s quality of life, embolization may help.
• Growth: If an AML shows rapid growth during follow-up imaging, it may indicate an increased risk of complications. Embolization can help manage the growth of the AML and prevent further enlargement.
• High risk features: Certain characteristics of an AML, such as an aneurysm within the tumor or association with a genetic condition such as TCS, may increase the risk of complications. In these cases, a doctor may consider embolization to mitigate the risks.

Generally, the decision to undergo AML embolization is made on an individual basis, considering the following factors:

• specific characteristics of the AML
• the person’s overall health
• the potential benefits and risks of the procedure

Experts generally consider AML embolization a safe procedure when performed by an experienced doctor.

As with any medical procedure, there are potential risks and complications associated with AML embolization. However, major complications are relatively uncommon.

Here is what a person can expect before and during AML embolization:

Before the procedure

• Consultation: A person will talk with a doctor to discuss the procedure, review their medical history, and address any concerns or questions. The doctor may also order imaging tests, such as an ultrasound or CT scan, to assess the size and location of the AML.
• Pre-procedure instructions: The individual may need to discontinue certain medications and fast (not eat or drink) for a certain period before the procedure. They should also arrange for transportation to and from the hospital or clinic.
• Anesthesia: Doctors may recommend local anesthesia with sedation or general anesthesia.

During the procedure

During the AML embolization procedure, the healthcare team will:

• Access the blood vessels: A doctor will insert a small catheter into a blood vessel, usually through the groin area. They guide it to the blood vessels supplying the AML in the kidney.
• Perform the embolization: Once the catheter reaches the targeted blood vessels, the doctor will inject embolization materials, such as tiny particles or coils, through the catheter. These materials block the blood supply to the AML, causing it to shrink and eventually absorb into the body.
• Monitor and support recovery: The healthcare team will closely monitor the person’s vital signs throughout the procedure. Afterward, the person will receive pain medication and other supportive measures to help manage discomfort or side effects.

As with any medical procedure, AML embolization carries certain risks and potential complications. They may include:

• bleeding at the catheter insertion site or within the kidney
• infection from the catheter insertion
• allergic reaction to the contrast dye used during the procedure
• kidney damage
• post-embolization syndrome, which is temporary flu-like symptoms
• reoccurrence of the AML

Recovery time varies for each person. However, most individuals experience gradual recovery over several weeks. After AML embolization, the recovery process involves the following:

• A hospital stay: Most people can go home on the same day, though some will require an overnight stay.
• Post-procedure care: A healthcare professional will provide instructions on wound care, pain management, and activity restrictions during recovery.
• Discomfort and pain: Some pain at the catheter insertion site is typical. A doctor may prescribe pain medication to help manage it.
• Activity restrictions: Individuals should avoid heavy lifting, strenuous exercise, and certain medications that may interfere with healing. A doctor or another healthcare professional will provide more information about these restrictions.
• Follow-up appointments: Scheduled appointments allow a doctor to monitor recovery and evaluate AML status. They may involve various imaging tests.
• A gradual return to typical activities: A person can gradually resume their daily activities based on guidance from a healthcare professional after they have allowed sufficient time for healing.

AML embolization is a minimally invasive procedure doctors use to treat renal AML, a noncancerous tumor in the kidney.

The procedure involves the insertion of a catheter into the blood vessels supplying the tumor, followed by the injection of embolic agents to block the blood flow and shrink the tumor.

AML embolization is generally safe and effective, with minimal risks and complications.

The recovery process after AML embolization involves post-procedure care, pain management, activity restrictions, and follow-up appointments. With medical guidance and care, individuals can expect a gradual return to typical activities and improved kidney health following the procedure.