TY - JOUR
T1 - RF Ablation of Giant Hemangiomas Inducing Acute Renal Failure
T2 - A Report of Two Cases
AU - van Tilborg, Aukje A J M
AU - Dresselaars, Helena F
AU - Scheffer, Hester J
AU - Nielsen, Karin
AU - Sietses, Colin
AU - van den Tol, Petrousjka M
AU - Meijerink, Martijn R
PY - 2016/11
Y1 - 2016/11
N2 - OBJECTIVE: In patients that require treatment for hepatic giant cavernous hemangiomas (GCH), radiofrequency ablation (RFA) has been suggested to represent a safe and effective alternative to invasive surgery. In a recent report of bipolar RFA, using two expandable needle electrodes, was uneventfully performed in patients with large GCH (>10 cm). The objective of this report is to present two cases in which bipolar RFA of symptomatic GCH was complicated by acute kidney injury.MATERIALS AND METHODS: In 2015 we treated two patients for very large symptomatic GCH (15.7 and 25.0 cm) with bipolar RFA during open laparotomy.RESULTS: In both patients the urine showed a red-brown discoloration directly after the ablation. They became anuric and presented with progressive dyspnea, tachypnea, and tachycardia, requiring hemodialysis for a period of 1 month in one case. Lab results revealed hemepigment-induced acute kidney. Both patients fully recovered and both showed a complete relief of symptoms at 3 months following the procedure.CONCLUSION: RFA for large GCHs can cause hemepigment-induced acute kidney injury due to massive intravascular hemolysis. The presented cases suggest that caution is warranted and advocate an upper limit regarding the volume of GCHs that can be safely ablated.
AB - OBJECTIVE: In patients that require treatment for hepatic giant cavernous hemangiomas (GCH), radiofrequency ablation (RFA) has been suggested to represent a safe and effective alternative to invasive surgery. In a recent report of bipolar RFA, using two expandable needle electrodes, was uneventfully performed in patients with large GCH (>10 cm). The objective of this report is to present two cases in which bipolar RFA of symptomatic GCH was complicated by acute kidney injury.MATERIALS AND METHODS: In 2015 we treated two patients for very large symptomatic GCH (15.7 and 25.0 cm) with bipolar RFA during open laparotomy.RESULTS: In both patients the urine showed a red-brown discoloration directly after the ablation. They became anuric and presented with progressive dyspnea, tachypnea, and tachycardia, requiring hemodialysis for a period of 1 month in one case. Lab results revealed hemepigment-induced acute kidney. Both patients fully recovered and both showed a complete relief of symptoms at 3 months following the procedure.CONCLUSION: RFA for large GCHs can cause hemepigment-induced acute kidney injury due to massive intravascular hemolysis. The presented cases suggest that caution is warranted and advocate an upper limit regarding the volume of GCHs that can be safely ablated.
U2 - https://doi.org/10.1007/s00270-016-1415-1
DO - https://doi.org/10.1007/s00270-016-1415-1
M3 - Article
C2 - 27387187
SN - 0174-1551
VL - 39
SP - 1644
EP - 1648
JO - Cardiovascular and interventional radiology
JF - Cardiovascular and interventional radiology
IS - 11
ER -