Pre-operative renal artery embolization and suprarenal IVC filter placement for prevention of fat embolization in renal angiomyolipoma with venous extension


      • Risk of pulmonary fat embolism in cases of IVC-invasive AML requires mechanical protection.
      • Concurrent preoperative RAE and IVC filter placement is feasible at minimal added risk.
      • Optimal timing is 24–48 h before surgery to balance revascularization and tumor shrinkage.
      • Retrievable IVC filters provide continued protection in the postoperative period.


      Though generally considered benign, angiomyolipomas can invade through the renal vein into the inferior vena cava, putting patients at risk of catastrophic pulmonary fat embolization. Venous invasion is thus an indication for surgical resection but is thought to increase the risk of adverse operative outcomes including intraoperative hemorrhage and embolization of fat and/or tumor thrombus. We report a novel approach to mitigating these complications illustrated in the case of a 43-year-old woman with IVC-invasive renal AML who underwent successful radical nephrectomy after concurrent pre-operative renal artery embolization and placement of a retrievable suprarenal IVC filter.


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