case_images: PMC11227672_01
case_images: A) Noncontrast CT axial section showing heteroattenuating lesion in left kidney with intratumoral fat density and perinephric hematoma. B) CECT showing intratumoral ruptured pseudoaneurysm (straight arrow). C) Virtual 3D reconstruction showing left accessory renal artery supplying lower pole of left kidney (curved arrow).
case_images: amed-31-022-g001.jpg
case_images: PMC11227672_01_amed-31-022-g001.jpg
case_images: F1
case_images: The angiographic anatomical evaluation revealed that the accessory left renal artery supplying the lower pole of the kidney provided the feeders to the AML (Figure 1).
case_images: A) Digital subtraction angiography run from left accessory renal artery (straight arrow) showing large angiomyolipoma with multiple intrasac pseudoaneurysms embolized using PVA particles. B) Fluoroscopic image showing coiling of feeder artery. C) Post-coiling angiography showing superselective and complete embolization of angiomyolipoma. Supply to normal renal parenchyma preserved (arrow head). D) Post-embolization (at 3 months) MRI T1W imaging showing reduction in tumor size (curved arrow).
case_images: amed-31-022-g002.jpg
case_images: PMC11227672_01_amed-31-022-g002.jpg
case_images: F2
case_images: PVA particles (300 to 500 microns) were used, followed by coiling of the feeder artery to AML using an 18-5-3 coil (Hilal, Cook). Post-coiling angiographic run was taken, showing complete embolization of angiomyolipoma and sparing of lower pole arterial supply to normal renal parenchyma (Figure 2).