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Renal Cysts: Less Sclerosant, Less Time, Satisfactory Results

January 28, 2008
Written by: , Filed in: Interventional Radiology
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The objective of a recent study was to evaluate the efficacy and long-term results of single-session 50% acetic acid sclerotherapy for treatment of simple renal cysts and to compare 5- and 20-minute sclerosant dwell technique results.
Single-session percutaneous drainage and 50% acetic acid is an effective and safe sclerosing agent for simple renal cysts.

Design and Participants
Retrospective review of 66 patients (39 women and 27 men aged 32 to 84 years) with simple renal cysts.

Over 9 years, patients underwent ultrasound or CT and MRI within 1 month prior to sclerotherapy. After preliminary evaluations, 50% acetic acid sclerotherapy was performed on 67 cysts. Irrigation was performed 3 to 4 times using 10 mL of normal saline without position changes. Cyst volumes were calculated on follow-up sonography and compared with those prior to sclerotherapy.

A 20-minute dwell time with position changes was performed in 32 cysts in 31 patients (group 1) and 8% of volume for a 5-minute dwell time in 35 cysts in 35 patients (group 2). Sonographic or CT follow-up was performed at 3 and 6 months for at least 1 year; 1 patient refused further evaluation at 7 months.

At follow-up, 21 of 32 cysts (66%) in group 1 and 22 of 35 cysts (63%) in group 2 had complete regression. Partial regression was observed in the remaining 24 cysts. The partial reduction rate of the cyst’s volume was 97.4% (91.3% to 99.4%) in group 1 and 96.9% (90.8% to 99.5%) in group 2. There were no differences in complete regression and partial volume reduction rates between groups.

Single-session percutaneous drainage and 50% acetic acid is an effective and safe sclerosing agent for simple renal cysts. In this study, no difference in results was seen between 5- and 20-minute dwell techniques, and both had superior effectiveness compared to single-session ethanol sclerotherapy.

Reviewer’s Comments
Symptomatic cysts are first aspirated, and ethanol at one third the volume of aspirated fluid (up to a maximum of 100 mL ethanol) is then injected into the cyst and allowed to dwell for 20 minutes and then aspirated back.

Sohail Contractor, MD

Kwon SH, Oh JH, et al. Efficacy of Single-Session Percutaneous Drainage and 50% Acetic Acid Sclerotherapy for Treatment of Simple Renal Cysts. Cardiovasc Intervent Radiol; 2007; 30 (November): 1227-1233


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