Transarterial embolization of renal

tumors improves surgical outcomes:

A case series
Henry A. Reinharta, Melhem
Ghalebb, Brian R. Davisa,∗
Introduction
 Almgard et al first popularized renal artery embolization
(RAE) in the 1970s.

 Renal artery embolization was originally used to treat

unresectable renal cancers that were symptomatic but is
now being increasingly used to augment surgical resection
Presentation Case

A retrospective case matched control from 2011-2014

Patients who received TAE along with surgery were compared to

those patients who underwent radical nephrectomy alone.

Data examined included patient demographics, operative

blood loss, operative time, transfusion requirements, length of
stay, tumor pathology, stage, and type of surgery.
Non Embolization Group
Tumor Stage Length Blood PRC Surgery
Size (min) loss
(cm) (cc)
Lap (R) Neph
4x4x3 T1 117 25 0
4x3x3 T1 138 50 0 Lap (R) Neph

5x5x4 T1 83 1400 4 (L) Neph

6x6x5 T1 117 250 0
Lap (R) Neph

5x4x4 114 431

(Mean)
Higher stage tumours in the Transarterial embolization Group
Tumor Stage Length Blood PRC Surgery
Size (mm) loss
(cm) (cc)
Lap (R) Neph
8x6x5 T3 129 300 0
12x10x9 T2 262 400 0 (R) Neph

6x5x4 T1 128 200 0 (R) Neph

8x7x6 T2 122 100 0
(L) Neph

9x7x6 160 250

(Mean)
Discussion

TAE allowed higher stage tumors of greater average

size to be removed with comparable outcomes.

There was no statistical difference between the two

groups for operative blood loss or length of stay

While the small sample size of our study limited the

power of our findings.
Discussion
• Zielinski et al.demonstrated an increase in five
and ten year survival with TAE when compared
to surgery alone. This was a non-randomized
study at a single institution and the difference
only applied to T2 and T3 tumor
 Facilitates nephrectomy in selected
patients

Reductions in transfusion
requirements

Demonstrated reduction in intraoperative blood

loss and duration of surgery in patients with
tumors of either large size or advanced stage .

Decreased tumor vascularity which

allows early ligation
Patophysiology
Immunomodulatory Effect

Tumor necrosis upregulates

lymphoproliferative state
Specific tumor response of natural
killer cells
Vascular Ischemic