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Q&A: Melania Trump had an embolization to treat a kidney condition. What is an embolization?

First Lady Melania Trump speaks at the White House on May 7. The White House announced Monday that Trump had an embolization procedure to treat a benign kidney condition.
(Susan Walsh / Associated Press)
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The White House announced that First Lady Melania Trump underwent an embolization procedure Monday to treat a benign kidney condition.

According to the statement, the treatment was a success. However, she is expected to remain at the Walter Reed National Military Medical Center for the rest of the week.

To find out what an embolization procedure entails and why it might be necessary, we spoke to Dr. Mark S. Litwin, professor and chairman of urology at UCLA.

Below he explains what conditions are most frequently treated with embolization, how the procedure works and potential minor side effects the first lady might experience.


Why do people get embolizations?

The purpose of an embolization is to cut off the blood supply to a lesion to cause it to shrink and ultimately die off.

What does an embolization procedure entail?

It involves threading a very tiny catheter, which is a hollow tube, up through one of the arteries of the body.

Usually it goes in through the top of the leg, and we thread it up through the aorta into the renal artery, which is the main artery that goes to the kidney. Then we put it into an artery that goes directly to the benign lesion.

Once that’s done, typically we squirt in some foam, or what’s called a coil. That obstructs the small artery that goes to the lesion, thereby cutting off the blood supply.

What types of kidney conditions are treated this way?

There is a type of benign tumor of the kidney called an angiomyolipoma, which is composed of a collection of blood vessels and fat cells and sometimes some random muscle cells. These are benign, but sometimes they can cause discomfort or even cause bleeding in a patient, so we often will embolize those.

The other one is an AVM, or arteriovenous malformation. An AVM is a pretty common thing we see throughout the body, but particularly in the kidney. It involves a collection of arteries and veins that kind of group themselves together in an abnormal way. It’s a benign condition, but it can cause bleeding in the urine, so we often embolize those.

How long does the procedure usually take?

It usually takes an hour or two.

Is it common to stay in the hospital for a week after an embolization procedure?

Embolizations for benign kidney conditions are usually done as an outpatient procedure — just come in the morning and go home that afternoon.

Why someone would be in a hospital for a week for this, I have no idea.

Are there possible side effects to worry about after an embolization?

Any medical procedure has a potential risk of side effects, sure.

The risk of an embolization includes minor things such as swelling and bruising or discomfort at the access point. That’s usually pretty minor.

Also, if too large of an artery ends up getting embolized that can be problematic. If it’s not just the branch that goes to the lesion, but one of the more major branches, then one of the risks is you could end up embolizing a whole wedge of kidney.

But if the patient is in a good medical center, those kinds of risks are pretty low.

And just to be clear, that tube you use is really tiny, right?

Yes. As we say in urology, it’s teeny weeny.

deborah.netburn@latimes.com

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