Effects of Sublingual Glyceryl Trinitrate Administration on the Quality of Preprocedure CT Angiography Performed to Plan Prostate Artery Embolization

Little, Mark W.; Macdonald, Andrew; Boardman, Philip; Bratby, Mark; Anthony, Suzie; Hadi, Mohammed El; Tapping, Charles R.

doi:10.1016/j.jvir.2017.09.019

Cited by 17 publications

(11 citation statements)

References 11 publications

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“…The LAVA sequences were obtained at a thickness of 3.6 mm, a 26 Â 21 FOV, and a 192 Â 192 matrix. Planning computed tomography (CT) angiography after administration of intravenous contrast (100 mL Niopam 370 Bracco UK Ltd., Wooburn, UK) and sublingual glyceryl trinitrate (GTN 2 metered doses of 0.4 mg; Ayrton Saunders Ltd., Runcorn, UK) was performed (5). A slice thickness of 0.625 mm was obtained with reconstructions in the transaxial plane of 1.25 mm and coronal and sagittal planes of 3 mm.…”

Section: Methodsmentioning

confidence: 99%

Prostatic artery embolization (PAE) in catheter-dependent patients with large prostatic (BPH) glands (>90 cc): early intervention essential

Tapping

Boardman

2019

Acta Radiol

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Background Prostate artery embolization (PAE) is safe and effective at improving lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). Purpose To assess the effectiveness of PAE on allowing successful voiding in patients with obstructive BPH (>90 cc) necessitating a urethral catheter for complete urinary retention. Material and Methods Ten consecutive patients with urethral catheters for obstructing BPH were included in the prospective study. Prostate arteries were embolized (Embosphere 300–500 um) and they had an attempted trial without catheter (TWOC) at two weeks and then at two-week intervals thereafter, if unsuccessful. They were clinically reviewed; an MRI was performed three and 12 months after PAE. Quality of life (QOL) questionnaires, International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF) were also performed. Results All cases were technically successful (100%). Eight patients had their catheters removed by their three-month follow-up (80%). The two cases that failed their TWOC by three months remained with a urethral catheter at 12-month follow-up. Seven of ten patients had their PAE procedure < 3 months following insertion of the urethral catheter and 100% of these had a successful TWOC before their three-month follow-up. Of the three patients that had their urethral catheter inserted > 3 months before their PAE (range 6–24 months), only 1/3 (33%) became catheter-free by 12 months after PAE. There was a dramatic reduction in LUTS and improvements in QOL indices, IPSS, and IIEF. There was no associated sexual dysfunction. Conclusion PAE is very successful in allowing spontaneous voiding in men with obstructing BPH requiring a urethral catheter. However, the PAE should be performed as soon as possible after the urethral catheter is inserted. Direct referral from acute urology services or emergency departments once the catheter is inserted are warranted.

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Section: Methodsmentioning

confidence: 99%

Prostatic artery embolization (PAE) in catheter-dependent patients with large prostatic (BPH) glands (>90 cc): early intervention essential

Tapping

Boardman

2019

Acta Radiol

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“…Mean acquisition time is 3 seconds for a range of 29.5 cm. Vasodilation performed with 800 μg of sublingual nitroglycerin administered 3-5 minutes before imaging increases PA diameter and peak opacification (25). Patients should be screened for hypotension and the use of phosphodiesterase inhibitors within the preceding 48 hours.…”

Section: Preprocedural Imagingmentioning

confidence: 99%

Prostatic Artery Embolization for Benign Prostatic Hyperplasia: Patient Evaluation, Anatomy, and Technique for Successful Treatment

et al. 2019

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“… 58 CBCT can also be used to certify correct catheterization of the PAs and exclude anastomoses that may lead to non-target embolization. 56,57 CTA, even with optimized protocols using sublingual glyceryl trinitrate 59 fails to identify most anastomoses. CBCT data can also be used for automatic vessel detection analysis, obviating the need for extensive anatomical knowledge.…”

Section: Prostatic Artery Embolization For Benign Prostatic Hyperplasmentioning

confidence: 99%

Modern imaging and image-guided treatments of the prostate gland: MR and ablation for cancer and prostatic artery embolization for benign prostatic hyperplasia

Dias

Bilhim

2019

BJR|Open

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Multiparametric MRI (mpMRI) has proven to be an essential tool for diagnosis, post-treatment follow-up, aggressiveness assessment, and active surveillance of prostate cancer. Currently, this imaging technique is part of the daily practice in many oncological centres. This manuscript aims to review the use of mpMRI in the set of prostatic diseases, either malignant or benign: mpMRI to detect and stage prostate cancer is discussed, as well as its use for active surveillance. Image-guided ablation techniques for prostate cancer are also reviewed. The need to establish minimum acceptable technical parameters for prostate mpMRI, standardize reports, uniform terminology for describing imaging findings, and develop assessment categories that differentiate levels of suspicion for clinically significant prostate cancer led to the development of the Prostate Imaging Reporting and Data System that is reviewed. Special focus will also be given on the most up-to-date evidence of prostatic artery embolization (PAE) for symptomatic benign prostatic hyperplasia (BPH). Management of patients with BPH, technical aspects of PAE, expected outcomes and level of evidence are reviewed with the most recent literature. PAE is a challenging technique that requires dedicated anatomical knowledge and comprehensive embolization skills. PAE has been shown to be an effective minimally-invasive treatment option for symptomatic BPH patients, that can be viewed between medical therapy and surgery. PAE may be a good option for symptomatic BPH patients that do not want to be operated and can obviate the need for prostatic surgery in up to 80% of treated patients.

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Effects of Sublingual Glyceryl Trinitrate Administration on the Quality of Preprocedure CT Angiography Performed to Plan Prostate Artery Embolization

Cited by 17 publications

References 11 publications

Prostatic artery embolization (PAE) in catheter-dependent patients with large prostatic (BPH) glands (>90 cc): early intervention essential

Prostatic artery embolization (PAE) in catheter-dependent patients with large prostatic (BPH) glands (>90 cc): early intervention essential

Prostatic Artery Embolization for Benign Prostatic Hyperplasia: Patient Evaluation, Anatomy, and Technique for Successful Treatment

Modern imaging and image-guided treatments of the prostate gland: MR and ablation for cancer and prostatic artery embolization for benign prostatic hyperplasia

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