Transcatheter Arterial Embolization for Autosomal Dominant Polycystic Kidney Disease: Exploratory Per-Kidney Volume Reduction and Procedural Efficiency Across Embolic Agents

Wednesday, April 15, 2026

11:24 AM - 11:33 AM ET

Location: 701A

Presenting Author(s)

Hiroki Satomura, MD, PhD (he/him/his)

Project Assistant Professor
Department of Diagnostic and Interventional Radiology, The University of Osaka Graduate School of Medicine, Japan

Author/Co-author(s)

YM

Yu Masuda, MD

medical staff
osaka University, Japan
KT

Kosuke Tomotake, MD

Clinical Fellow
Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Japan
YK

Yuji Koretsune, MD

Clinical Fellow
Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Japan
HY

Hiroki Yano

PhD Student
Department of Diagnostic and Interventional Radiology Osaka University Graduate School of Medicine, Japan
DK

Daisuke Katayama, MD, PhD

Assistant Professor
Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Japan
Yasushi Kimura, MD, PhD

Project Assistant Professor
Osaka University Graduate School of Medicine, Japan
KT

Kaishu Tanaka

assistant professor
Department of Diagnostic and Interventional Radiology Osaka University Graduate School of Medicine, Japan
YO

Yusuke Ono

Assistant Professor
Department of Diagnostic and Interventional Radiology Osaka University Graduate School of Medicine, Japan
HH

Hiroki Higashihara

associate professor
Department of Diagnostic and Interventional Radiology Osaka University Graduate School of Medicine, Japan
NT

Noriyuki Tomiyama

professor
Department of Diagnostic and Interventional Radiology Osaka University Graduate School of Medicine, Japan

Purpose: To quantify per-kidney volumetric reduction after transcatheter arterial embolization (TAE) for autosomal dominant polycystic kidney disease (ADPKD) and to compare procedural efficiency across embolic agents.

Materials and Methods: In this single-center retrospective cohort (2006–2024), consecutive symptomatic ADPKD patients underwent TAE; several had same-day bilateral procedures. Indications were abdominal distension and mass-effect symptoms in all cases; in one case, space creation before renal transplantation was intended. Analyses were per kidney. One volumetric assessment was performed 3–21 months post-TAE. The primary endpoint was percent change in kidney volume (median [min–max]). Secondary endpoints included procedure time (min), cumulative frontal air kerma (CFAK, mGy), contrast volume, angiographic completeness, complications (Common Terminology Criteria for Adverse Events [CTCAE] v5.0), and retreatment. Radiation metrics were variably recorded in early-era cases; dose analyses used available-case data. Nonparametric tests were used throughout (two-sided α=0.05): Kruskal–Wallis for four-group comparisons and a prespecified N-butyl cyanoacrylate (NBCA) vs non-NBCA Mann–Whitney U test.

Results: Sixteen kidneys were treated (median patient age 52 years [27–67]; 9 women/7 men): NBCA (n=6), coils (n=4), microspheres (n=4), ethanol (n=2). Median volume reduction was similar—NBCA 49.4% (37.8–64.1), coils 49.6% (23.7–50.0), microspheres 48.1% (19.0–57.3), ethanol 43.0% (39.3–46.8); Kruskal–Wallis p=0.997. Procedure time differed—NBCA 43.0 (27.0–63.0) min vs coils 139.0 (87.0–146.0), microspheres 96.0 (55.0–138.0), ethanol 92.5 (68.0–117.0); p=0.011. CFAK tended to be lower with NBCA: 27.9 (16.7–39.1) mGy vs coils 330.8 (134.2–420.2) mGy; microspheres 108.4 mGy (n=1); ethanol 35.8 mGy (n=1); p=0.064. In available-case dose data (8/16 procedures), median CFAK was 27.9 mGy (NBCA, n=2) vs 210.9 mGy (non-NBCA, n=6); Mann–Whitney p=0.143. Angiographic occlusion was complete in 16/16 (100%); no retreatments and no CTCAE grade ≥3 events occurred. All patients reported symptom improvement, limited to mild pain/fever.

Conclusion: TAE for symptomatic ADPKD achieved substantial per-kidney volume reduction with an excellent safety profile. While shrinkage did not differ by agent, NBCA was associated with significantly shorter procedures and a trend toward lower radiation dose, suggesting a procedural-efficiency advantage. Prospective validation with standardized follow-up and size-adjusted dose reporting is warranted.