Selective arterial embolization of angiomyolipoma leading to pulmonary hypertension
Lee Franklin; Aaronson S. David; Blaschko Sarah; Barbosa Phil; Wu K. Alex; Eisenberg Michael; Erickson A. Bradley; McAninch W. Jack;
Department of Urology, University of California, San Francisco, California, USA
OBJECTIVES: To report two cases of secondary pulmonary hypertension resulting from microsphere extravasation following selective arterial embolization of renal angiomyolipoma, its diagnosis, and management. METHODS: We reviewed the cases of two patients at the University of California, San Francisco, treated with selective arterial embolization for management of their angiomyolipoma (AML) using Tris-Acryl Gelatin Microspheres. RESULTS: Both patients were women, ages 51 and 77. Indications for treatment were the following: Patient 1 was treated for a large asymptomatic AML. Patient 2 was treated for a symptomatic, bleeding AML. Both patients developed progressive hypoxia following selective arterial embolization using Tris-Acryl Gelatin Microspheres. Each patient underwent a subsequent work up including a CT chest, echocardiogram, and chest x-ray. Both demonstrated significant pulmonary hypertension following their procedure and were discharged with supplemental oxygen. CONCLUSIONS: Selective arterial embolization of AML with microsphere extravasation into the pulmonary vasculature can lead to pulmonary hypertension and hypoxemia.