Prostataarterienembolisation (PAE)

Kovács, Attila

doi:10.1007/s00117-017-0248-5

Cited by 8 publications

(4 citation statements)

References 42 publications

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“…Conversely, TPLA demonstrated a 0% rate of retrograde ejaculation proving to be a useful alternative treatment in young men [24][25][26][27]. Recently introduced prostatic artery embolisation demonstrated satisfactory results in terms of retrograde ejaculation rate [28][29][30]. However, its results regarding prostate volume, IPSS and QoL appear to be similar to those provided by other mini-invasive techniques including TPLA.…”

Section: Discussionmentioning

confidence: 92%

3-T MRI and clinical validation of ultrasound-guided transperineal laser ablation of benign prostatic hyperplasia

et al. 2021

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Background Transperineal laser ablation (TPLA) of the prostate is a novel, mini-invasive option for men with lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH). Our aim was to assess the impact of ultrasound-guided TPLA regarding urodynamic improvement and sexual function, monitoring clinical data, postprocedural complications and imaging findings at 3-T multiparametric magnetic resonance imaging. Methods Forty-four patients aged ≥ 50 affected with moderate to severe LUTS (International Prostate Symptoms score ≥ 12) due to benign prostatic obstruction and refractoriness, intolerance or poor compliance to medical therapies underwent US-guided TPLA between May 2018 and February 2020. Clinical measurements included PSA, uroflowmetry, sexual function assessment (using the International Index of Erectile Function and Male Sexual Health Questionnaire-Ejaculatory Dysfunction short form) and quality of life questionnaire. Adverse events were evaluated using the Clavien-Dindo scale. Volume changes were measured by MRI and automatic segmentation software during 1-year follow-up. Registration: NCT04044573 – May 5th, 2018, https://www.clinicaltrials.gov Results MRI assessed the changes over time with a 53% mean reduction of adenoma volume and 71% of the ablated area, associated with clinical and functional improvement and resolution of LUTS in all cases. Five of 44 patients (11.3%) had urinary blockage due to clots and required re-catheterisation for 2 weeks. The overall adverse event rate was 7%. Conclusion US-guided TPLA performed as a safe, manageable and effective treatment for LUTS. It could be considered an alternative effective mini-invasive procedure to standard treatments for BPH in the outpatient setting.

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Section: Discussionmentioning

confidence: 92%

3-T MRI and clinical validation of ultrasound-guided transperineal laser ablation of benign prostatic hyperplasia

et al. 2021

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“…Cone-beam computed tomography at the time of angiography is used to ensure accurate PAE and reduce nontarget embolization. Numerous systematic reviews and meta-analyses revealed significant improvements in LUTS (up to 13.71) and QoL (up to 2.9), with a low risk of complications in short-, mid-, and long-term follow-up (up to 6.5 years) [11,[26][27][28][29][30][31]. Clinical and technical success rates were reported as between 76.3 and 100% and 76.7 and 100%, respectively [30].…”

Section: Prostate Artery Embolizationmentioning

confidence: 99%

Interventional therapy in benign conditions of the prostate

Kovács

2020

Radiologe

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“…Nevertheless, PAE is a technically challenging procedure, and it remains unclear, which patients may be suitable for the intervention and benefit in the clinical long-term outcome. Exact knowledge about the vessel anatomy is supportive for interventional planning as vascular anatomy of iliac branches is heterogeneous and complex, and the origin of the prostatic artery varies between different PA types 9 – 11 . Furthermore, the interventional radiologist can prevent post-interventional complications by temporarily occluding collateral blood vessels to surrounding tissues (bladder, penis, and rectum) that become apparent during the intervention.…”

Section: Introductionmentioning

confidence: 99%

Value of magnetic resonance angiography before prostatic artery embolization for intervention planning

Boschheidgen,

Ullrich,

Al-Monajjed

et al. 2024

Sci Rep

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Knowledge about anatomical details seems to facilitate the procedure and planning of prostatic artery embolization (PAE) in patients with symptomatic benign prostatic hyperplasia (BPS). The aim of our study was the pre-interventional visualization of the prostatic artery (PA) with MRA and the correlation of iliac elongation and bifurcation angles with technical success of PAE and technical parameters. MRA data of patients with PAE were analysed retrospectively regarding PA visibility, PA type, vessel elongation, and defined angles were correlated with intervention time, fluoroscopy time, dose area product (DAP), cumulative air kerma (CAK), contrast media (CM) dose and technical success of embolization. T-test, ANOVA, Pearson correlation, and Kruskal–Wallis test was applied for statistical analysis. Between April 2018 and March 2021, a total of 78 patients were included. MRA identified the PA origin in 126 of 147 cases (accuracy 86%). Vessel elongation affected time for catheterization of right PA (p = 0.02), fluoroscopy time (p = 0.05), and CM dose (p = 0.02) significantly. Moderate correlation was observed for iliac bifurcation angles with DAP (r = 0.30 left; r = 0.34 right; p = 0.01) and CAK (r = 0.32 left; r = 0.36 right; p = 0.01) on both sides. Comparing the first half and second half of patients, median intervention time (125 vs. 105 min.) and number of iliac CBCT could be reduced (p < 0.001). We conclude that MRA could depict exact pelvic artery configuration, identify PA origin, and might obviate iliac CBCT. Vessel elongation of pelvic arteries increased intervention time and contrast media dose while the PA origin had no significant influence on intervention time and/or technical success.

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Prostataarterienembolisation (PAE)

Abstract: Data concerning the long-term efficacy are missing at present.

Cited by 8 publications

References 42 publications

3-T MRI and clinical validation of ultrasound-guided transperineal laser ablation of benign prostatic hyperplasia

3-T MRI and clinical validation of ultrasound-guided transperineal laser ablation of benign prostatic hyperplasia

Interventional therapy in benign conditions of the prostate

Value of magnetic resonance angiography before prostatic artery embolization for intervention planning

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