Case-Control Comparison of Conventional End-Hole versus Balloon-Occlusion Microcatheter Prostatic Artery Embolization for Treatment of Symptomatic Benign Prostatic Hyperplasia

Ayyagari, Raj; Powell, Taylor; Staib, Lawrence H.; Chapiro, Julius; Schoenberger, Steven; Devito, Ralph; Pollak, Jeffrey

doi:10.1016/j.jvir.2019.05.033

Cited by 16 publications

(6 citation statements)

References 15 publications

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“…27 Results have demonstrated balloon occlusion PAE is as effective as conventional microcatheter PAE, with the potential to reduce nontarget embolization. 28,29 The low complication rate identified in our study mirrors previous work, indicating PAE is a safe procedure.…”

Section: Discussionsupporting

confidence: 87%

Initial Canadian Experience of Prostate Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: Midterm Outcomes

et al. 2020

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Introduction: This study aimed to assess the midterm outcomes and safety of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH). Methods: A single-center, retrospective review of PAE performed for BPH was performed. Validated International Prostate Symptom Score (IPSS), quality of life (QoL) index, and International Index for Erectile Function (IIEF-5) questionnaires were completed at baseline and at least 12 months post-procedure. Prostate imaging was performed preprocedure as well as 3 months and 12 months post-procedure to assess prostate volume (PV). Uroflowmetry was also performed at baseline and 12 months post-procedure to assess urine flow rate (Qmax) and post-void residual (PVR) volume. Adverse events were graded according to Society of Interventional Radiology (SIR) guidelines. Results: Eighty male patients underwent the PAE procedure (mean age 69 years). Prostate volume decreased significantly from a mean volume 156 to 107 mL after 12 months post-procedure, commensurate with a mean reduction of 27.5% ( P < .05). Significant improvements were seen in IPSS (21.8 vs 10.5) and QoL (4.5 vs 2.0) from baseline to 12 months post-procedure ( P < .05). There was no significant change in IIEF-5 score. There was a significant reduction in PVR (202 vs 105 mL) and improvement in Qmax (5.9 vs 10.0 mL/s) between baseline and 12 months post-procedure ( P < .05). No major complications occurred; 4 minor complications occurred (SIR grade A or B). Conclusion: Prostate artery embolization achieved a clinically and statistically significant prostate volume reduction, symptom and QoL improvement, and enhanced uroflowmetry parameters in patients with BPH.

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Section: Discussionsupporting

confidence: 87%

Initial Canadian Experience of Prostate Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: Midterm Outcomes

et al. 2020

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“…A total of 263 articles were removed after reading the abstract. Of the remaining 115 studies assessed for full-text eligibility, 32 studies with a total of 2116 patients (ranging from 11–199) were selected for data extraction [ 5 , 6 , 7 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. A PRISMA flow diagram depicts the process of study selection ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Postembolization Syndrome after Prostatic Artery Embolization: A Systematic Review

et al. 2020

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Postembolization syndrome (PES) is the most common side effect of vascular embolization of solid organs. The aim of this review was to determine the incidence of PES and its individual components after prostatic artery embolization (PAE). A systematic review with a pre-specified search strategy for PubMed, Embase, Web of Science and Cochrane Library was performed according to PRISMA guidelines. Studies in English regarding PAE in humans with 10 or more participants were eligible for inclusion. No restrictions on participant demographics or PAE technique were imposed. The search returned 378 references, of which 32 studies with a total of 2116 patients met the inclusion criteria. The results for overall PES frequency and individual PES components were presented as median (interquartile range, (IQR)). Overall median PES frequency was 25.5% (12.5–45.8). The two most frequent individual PES components were dysuria/urethral burning and local pain, with a median frequency of 21.7% (13.8–33.3) and 20% (5.4–29.4), respectively. Most outcome measures were characterized by a marked lack of uniformity and inconsistency in reporting across studies. Development of a uniform reporting system would help the clinicians recognize and treat PES accordingly.

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“…Other protective measures such as the use of re ux-controlling and balloon occlusion microcatheters were scarcely described so far and can potentially reduce the incidence of complications after PAE, specially NTE (11,12). The aim of this study is to evaluate feasibility, e cacy, and safety of PAE using a re ux control microcatheter in patients with LUTS / BPH.…”

Section: Introductionmentioning

confidence: 99%

Prostatic Artery Embolization Using Reflux-control Microcatheter: Prospective Experience Addressing Feasibility.

Assis

Kawakami

Moreira

et al. 2022

Preprint

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Purpose: To describe the initial experience regarding efficacy and safety of Prostatic Artery Embolization (PAE) using a reflux control microcatheter. Materials and methods: This is a prospective, single-center investigation that included 10 patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline, 3-month and 12-month efficacy endpoints were obtained for all patients, and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging (MRI) and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. Complications were assessed using the Cirse classification system. Results: Ten patients entered statistical analysis and presented with significant LUTS improvement 12 months after PAE, as follows: mean IPSS reduction of 86.6% (2.8 vs. 20.7, -17.9, P < 0.001), mean QoL reduction of 79.4% (1.1 vs. 5.4, -4.3, P < 0.001), mean prostatic volume reduction of 38.4% (69.3 cm3 vs. 112.5 cm3, - 43.2 cm3, P < 0.001), mean peak urinary flow (Qmax) increase of 199.4% (19.9 mL/s vs. 6.6 mL/s, +13.3 mL/s, P = 0.006) and mean PSA reduction of 50.1% (3.0 ng/mL vs. 6.1 ng/mL, -3.0 ng/mL, P < 0.001). One patient (10%) needed transurethral resection of the prostate (TURP) after PAE due to a ball-valve effect. One patient (10%) needed coil protective embolization of a high flow intraprostatic anastomosis. One microcatether (10%) needed to be replaced during PAE due to occlusion. Non-target embolization was not observed in the cohort.Conclusion: This initial experience suggests that PAE using a reflux control microcatheter is effective and safe for the treatment of LUTS attributed to BPH. High flow intraprostatic anastomosis still need coil protective embolization to avoid NTE even with the use of reflux-control microcatheters.

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Case-Control Comparison of Conventional End-Hole versus Balloon-Occlusion Microcatheter Prostatic Artery Embolization for Treatment of Symptomatic Benign Prostatic Hyperplasia

Cited by 16 publications

References 15 publications

Initial Canadian Experience of Prostate Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: Midterm Outcomes

Initial Canadian Experience of Prostate Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: Midterm Outcomes

Postembolization Syndrome after Prostatic Artery Embolization: A Systematic Review

Prostatic Artery Embolization Using Reflux-control Microcatheter: Prospective Experience Addressing Feasibility.

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