RF Ablation of Giant Hemangiomas Inducing Acute Renal Failure: A Report of Two Cases

Aukje A J M van Tilborg, Helena F Dresselaars, Hester J Scheffer, Karin Nielsen, Colin Sietses, Petrousjka M van den Tol, Martijn R Meijerink

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1644-1648
Number of pages5
JournalCardioVascular and Interventional Radiology
Volume39
Issue number11
DOIs
Publication statusPublished - Nov 2016

Cite this

@article{8c9459ae1a2842f58600299595b6d78e,
title = "RF Ablation of Giant Hemangiomas Inducing Acute Renal Failure: A Report of Two Cases",
abstract = "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.",
author = "{van Tilborg}, {Aukje A J M} and Dresselaars, {Helena F} and Scheffer, {Hester J} and Karin Nielsen and Colin Sietses and {van den Tol}, {Petrousjka M} and Meijerink, {Martijn R}",
year = "2016",
month = "11",
doi = "10.1007/s00270-016-1415-1",
language = "English",
volume = "39",
pages = "1644--1648",
journal = "CardioVascular and Interventional Radiology",
issn = "0174-1551",
publisher = "Springer Verlag",
number = "11",

}

RF Ablation of Giant Hemangiomas Inducing Acute Renal Failure : A Report of Two Cases. / van Tilborg, Aukje A J M; Dresselaars, Helena F; Scheffer, Hester J; Nielsen, Karin; Sietses, Colin; van den Tol, Petrousjka M; Meijerink, Martijn R.

In: CardioVascular and Interventional Radiology, Vol. 39, No. 11, 11.2016, p. 1644-1648.

Research output: Contribution to journalArticleAcademicpeer-review

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 - 10.1007/s00270-016-1415-1

DO - 10.1007/s00270-016-1415-1

M3 - Article

VL - 39

SP - 1644

EP - 1648

JO - CardioVascular and Interventional Radiology

JF - CardioVascular and Interventional Radiology

SN - 0174-1551

IS - 11

ER -