Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study

Amouyal, G.; Thiounn, Nicolas; Pellerin, Olivier; Yc, Lin; Giudice, Costantino Del; Dean, Carolyn; Pereira, Héléna; Châtellier, Gilles; Sapoval, Marc

doi:10.1007/s00270-015-1267-0

Cited by 59 publications

(27 citation statements)

References 24 publications

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“…The effect of PAE on ejaculatory function was reported by 11 of the reviewed studies. There were no instances of retrograde ejaculation in 5 cohort studies totaling 340 patients (39,41,43,44,46,48), 1 cohort (34) reported 5 of 51 cases with dry or reduced ejaculation after PAE, and another cohort (35) showed reduced ejaculation in 14 of 97 patients. In the prospective UK-ROPE registry (32), 24.1% of patients reported retrograde ejaculation following PAE; however, the data were confounded by many patients having preexisting retrograde ejaculation related to medical therapy.…”

Section: Safety Of Paementioning

confidence: 99%

Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology

McWilliams

Bilhim²,

Carnevale

et al. 2019

Journal of Vascular and Interventional Radiology

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BPH ¼ benign prostatic hyperplasia, IIEF ¼ International Index of Erectile Function, IPSS ¼ International Prostate Symptom Score, LUTS ¼ lower urinary tract symptoms, MIST ¼ minimally invasive surgical therapies, OP ¼ open prostatectomy, PAE ¼ prostatic artery embolization, PVR ¼ postvoid residual, QOL ¼ quality of life, RCT ¼ randomized controlled trial, TURP ¼ transurethral resection of the prostate, UK-ROPE ¼ United Kingdom Register of Prostate Embolization BACKGROUND Benign prostatic hyperplasia (BPH) describes the proliferation of the glandular and stromal tissue in the transition zone of the prostate, which may result in bladder outlet obstruction and consequent lower urinary tract symptoms (LUTS). The prevalence of BPH increases with age, affecting more than 70% of men older than 70 years (1), and one fourth of men older than 70 years have moderate to severe LUTS that impair their quality of life (QOL) (2,3). Thus, BPH and ensuing LUTS represent a significant health issue affecting millions of men. The International Prostate Symptom Score (IPSS; also known as the American Urologic Association Symptom Index) is a validated instrument that quantifies a patient's subjective urinary symptoms on a 35-point scale (4). The IPSS also incorporates a urinary QOL score, which assesses how the patient feels overall about his urinary symptoms. Nearly all studies assessing BPH treatments for LUTS use the IPSS and QOL scores to assess patients before and after treatment. A 3-point change in IPSS is noticeable by a man with LUTS (5), and a 30% reduction in IPSS is considered clinically acceptable for a treatment to be considered effective (6,7). Medical therapies, including a-1 blockers and 5-a reductase inhibitors, are the mainstay of treatment for mild to moderate LUTS. The symptomatic relief is relatively modest, with IPSS improvement in the range of 3-7 points (8). Although generally considered safe, medical

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Section: Safety Of Paementioning

confidence: 99%

Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology

McWilliams

Bilhim²,

Carnevale

et al. 2019

Journal of Vascular and Interventional Radiology

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“…The authors also choose to not consider hemorrhage requiring blood transfusion as a complication in the TURP cohort. If we adjust the Gao data to be more in line with published standards, we find that PAE cohort consisted of no major complications and the TURP cohort experienced major complications in 7.5% (4/53) of patients (Amouyal et al 2016a). The lack of any retrograde ejaculation, impotence, or incontinence in the TURP group has also raised questions regarding this study's adverse event reporting and would perhaps further the adverse event margin (Wang et al 2016).…”

Section: Complicationsmentioning

confidence: 77%

“…Recently, prostate artery embolization (PAE) has been developed as a minimally invasive means to treat BPH related LUTS. Initial early and midterm results have been very promising (Bilhim et al 2013a;Li et al 2015;Pisco et al 2013a;Pisco et al 2011;Pisco et al 2012;Pisco et al 2013b;Pisco et al 2016a;Pisco et al 2016b;Antunes et al 2013;Bagla et al 2014;Ray et al 2018;Abt et al 2018;Grosso et al 2015;Kurbatov et al 2014;Wang et al 2015;Wang et al 2016;Amouyal et al 2016a;Carnevale et al 2010;Carnevale et al 2011;Carnevale et al 2012;De Assis et al 2015;Gao et al 2014;Bilhim et al 2015;Carnevale et al n.d.;Goncalves et al 2016;Bilhim et al 2013b;Yu et al 2017;Amouyal et al 2016b;Bagla et al 2013;Carnevale et al 2014). As further data is being published this exciting technique is slowly moving from the research setting to everyday clinical practice as demonstrated by its mention in the updated National Institute for Health and Care Excellence (NICE) guidelines for LUTS.…”

Section: Introductionmentioning

confidence: 99%

Prostate embolization: patient selection, clinical management and results

Young

Golzarian

2019

CVIR Endovasc

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Background: Prostate artery embolization is an emerging technique, that with the continued publication of promising data, is slowly moving from the research to the everyday clinical setting. Main body: This paper reviews the patient selection, clinical management and expected results of prostate artery embolization. Patient selection is paramount in delivering the desired results for any procedure. Likewise, the ability to clinically manage patients in the pre-operative and post-operative setting is an important skill to acquire when implementing new techniques. This paper introduces important urologic measurements/tests, patient selection paradigms, and clinical management concepts for interventional radiologists. It also reviews the outcomes patients can expect following prostate artery embolization as well as the complication profile. Conclusion: Prostate artery embolization is a promising technique for the treatment of benign prostatic hyperplasia induced lower urinary tract symptoms.

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“…Amouyal et al reported their first experience of PAE using proximal embolization first then embolize distal (PEr-FecTED) technique for treating LUTS in 35 consecutive patients with BPH in 2015. 37 Although The PErFecTED technique was originally introduced by Carnevale et al 38 in 2014, there had been no data reported outside from the Sao Paulo group that initiated this technique. Overall immediate technical success of PAE was 100% and PErFecTED technique was feasible in 68% of patients.…”

Section: Techniques and Outcomes Of Paementioning

confidence: 99%

Review of Current Literature for Prostatic Artery Embolization

Isaacson

Burke

2016

Semin intervent Radiol

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Prostatic artery embolization (PAE) is an emerging, novel interventional technique in the management of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). BPH is a common clinical condition in middle-aged and elderly men resulting in LUTS, including nocturia, urinary frequency, urgency, decreased urinary flow rates, hesitancy, and incomplete bladder emptying. Traditionally, LUTSs have been managed by medical or surgical therapies. Since the initial incidental discovery that selective PAE performed for uncontrolled bleeding secondary to BPH resulted in improved LUTS, the technique has continually evolved with a growing body of evidence supporting its safety and efficacy. However, despite the available data, PAE has yet to be established as a standard-of-care treatment option for patients with LUTS/BPH. In this article, the authors review the history and current state of PAE, including published data from case reports, animal studies, retrospective/prospective cohort studies, and prospective randomized controlled trials.

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Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study

Abstract: PAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons.

Cited by 59 publications

References 24 publications

Prostate embolization: patient selection, clinical management and results

Review of Current Literature for Prostatic Artery Embolization

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