Journal of vascular and interventional radiology : JVIR · 2026
Impact on renal function, tumor volume, and complications of transarterial embolization for renal angiomyolipomas: An Evidence-Based systematic review and meta-analysis.
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Orra Adriana Fudaba, Orra Soraya Hussein, Nabhan Martinez Juan Victor, Pinhata Otoch José, Shiomi da Cruz José Arnaldo
Аннотация
PURPOSE: To evaluate the effect of transarterial embolization (TAE) on tumor burden, renal function, and safety in renal angiomyolipoma (AML), and to identify drivers of between-study heterogeneity.
MATERIALS AND METHODS: Systematic review and meta-analysis following PRISMA and prospectively registered in PROSPERO (number on the title page). Major databases were searched through January 2024. Morphologic response was expressed as percentage reduction from baseline (random-effects ratio of means; medians converted by Wan's method); proportions were pooled by arcsine transformation. Risk of bias was assessed with ROBINS-I, RoB 2, and the JBI checklist.
RESULTS: Seventy-nine studies (1,798 patients) were included. TAE reduced tumor volume by 55.7% (95% CI, 49.3-61.3%; I2 = 85.6%; k = 18) and diameter by 34.2% (95% CI, 29.1-38.9%; I2 = 70.1%; k = 43). The interval to post-procedural imaging accounted for 50.7% of the between-study variance in volume reduction (P = .002); predicted reduction rose from 44% at 1 month to 63% at 36 months, a gradient three cohorts with serial imaging reproduced within-study. Serum creatinine and estimated glomerular filtration rate showed no clinically meaningful change from baseline. Pooled technical and clinical success were 98% and 97%; adverse events other than post-embolization syndrome occurred in 3%, and post-embolization syndrome in 46%.
CONCLUSIONS: TAE achieves substantial, strongly time-dependent tumor reduction with high procedural success and few adverse events. Renal function was stable relative to baseline, but no included study used a surveillance comparator. Standardized outcome definitions and prespecified imaging intervals are needed before pooled estimates can guide patient selection.
MATERIALS AND METHODS: Systematic review and meta-analysis following PRISMA and prospectively registered in PROSPERO (number on the title page). Major databases were searched through January 2024. Morphologic response was expressed as percentage reduction from baseline (random-effects ratio of means; medians converted by Wan's method); proportions were pooled by arcsine transformation. Risk of bias was assessed with ROBINS-I, RoB 2, and the JBI checklist.
RESULTS: Seventy-nine studies (1,798 patients) were included. TAE reduced tumor volume by 55.7% (95% CI, 49.3-61.3%; I2 = 85.6%; k = 18) and diameter by 34.2% (95% CI, 29.1-38.9%; I2 = 70.1%; k = 43). The interval to post-procedural imaging accounted for 50.7% of the between-study variance in volume reduction (P = .002); predicted reduction rose from 44% at 1 month to 63% at 36 months, a gradient three cohorts with serial imaging reproduced within-study. Serum creatinine and estimated glomerular filtration rate showed no clinically meaningful change from baseline. Pooled technical and clinical success were 98% and 97%; adverse events other than post-embolization syndrome occurred in 3%, and post-embolization syndrome in 46%.
CONCLUSIONS: TAE achieves substantial, strongly time-dependent tumor reduction with high procedural success and few adverse events. Renal function was stable relative to baseline, but no included study used a surveillance comparator. Standardized outcome definitions and prespecified imaging intervals are needed before pooled estimates can guide patient selection.