Prostate Artery Embolization for Benign Prostate Hyperplasia Review: Patient Selection, Outcomes, and Technique

Hashem, Essam; Elsobky, Sherif; Khalifa, Mohamed

doi:10.1053/j.sult.2020.04.001

Cited by 8 publications

(17 citation statements)

References 62 publications

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“…Many prefer the use of CT due to the speed of acquisition, spatial resolution and the ability to visualize very small arteries ( Figure 1 ) [ 14 , 27 , 43 ]. CT angiography may also help identify the origins of the prostatic artery, which can be one of the more challenging steps in the procedure [ 27 ].…”

Section: Pre-procedural Patient Evaluationmentioning

confidence: 99%

“…If the prostate artery is not well identified or the origin is difficult to find on the initial DSA run, an additional angiogram can be performed at 45 degrees. If the origin of the prostate artery is still not clear, a cone beam CT can be performed to help identify the prostatic artery [ 26 , 27 , 43 ]. An injection of 50% diluted contrast is power injected via the 5F catheter within the internal iliac artery at a rate of 4 mL/sec for a total of 16 mL.…”

Section: Techniquesmentioning

confidence: 99%

“…Potential sites include the bladder, seminal vesicles, rectum and the penis. Cone beam CT or rotation angiography may be used to confirm no evidence of non-target embolization and to ensure the entire hemiprostate shows enhancement [ 26 , 27 , 43 ]. When using cone beam CT, the injection needs to be done very slowly to minimize reflux and contrast filling of more proximal branches thereby giving false positive sites of non-target embolization.…”

Section: Techniquesmentioning

confidence: 99%

“…The prostate arteries are very small and prone to vasospasm upon manipulation [ 43 ]. Nitroglycerin should be readily available on the Table 2 and can be given intra-arterially as needed.…”

Section: Techniquesmentioning

confidence: 99%

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Prostate Artery Embolization—Review of Indications, Patient Selection, Techniques and Results

Naidu

Narayanan

Saini

et al. 2021

JCM

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Lower urinary tract symptoms (LUTS) due to benign prostatic hypertrophy (BPH) are a very common problem in men ranging from mild urinary symptoms to recurrent urinary tract infections or renal failure. Numerous treatment options are available ranging from conservative medical therapies to more invasive surgical options. Prostate artery embolization (PAE) has emerged as a novel treatment option for this common problem with clinical efficacy comparable to the current surgical gold standard, transurethral resection of the prostate (TURP). PAE offers fewer complications and side effects without a need for general anesthesia or hospitalization. This review discusses the indications for prostate artery embolization in addition to LUTS, patient evaluation in patients with LUTS, PAE technique and clinical results, with an emphasis on efficacy and safety.

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Section: Pre-procedural Patient Evaluationmentioning

confidence: 99%

Section: Techniquesmentioning

confidence: 99%

Section: Techniquesmentioning

confidence: 99%

“…The prostate arteries are very small and prone to vasospasm upon manipulation [ 43 ]. Nitroglycerin should be readily available on the Table 2 and can be given intra-arterially as needed.…”

Section: Techniquesmentioning

confidence: 99%

See 2 more Smart Citations

Prostate Artery Embolization—Review of Indications, Patient Selection, Techniques and Results

Naidu

Narayanan

Saini

et al. 2021

JCM

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show abstract

“…5 PAE has significantly lower risk of severe adverse events compared with standard urological interventions. [6][7][8][9][10] PAE is often a challenging procedure requiring certain level of knowledge of the arterial anatomy and set of skills, due to varying degrees of atherosclerosis commonly encountered in this age group. 11 We aim to highlight important anatomical data related to PA that are essential for successful PAE as well as radiation exposure considerations, which can be beneficial in such a relatively lengthy procedure.…”

Section: Introductionmentioning

confidence: 99%

Prostatic Artery Embolization for Benign Prostatic Hyperplasia: Anatomical Aspects and Radiation Considerations from a Case Series of 210 Patients

Shaker

Hashem

Abdelrahman

et al. 2021

The Arab Journal of Interventional Radiology

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Context Prostatic artery embolization (PAE) has been established as a safe and effective treatment option for symptomatic benign prostatic hyperplasia (BPH). Thorough knowledge of detailed prostatic artery (PA) anatomy is essential. Aims The aim of this study was to provide a pictorial review of PA anatomy and prevalence of related anatomical variants, in addition to other anatomical and radiation dose considerations. Settings and Design Case series and review of literature. Materials and Methods We performed PAE for 210 patients from November 2015 to November 2020 under local anesthesia only. Anatomy, procedure duration, fluoroscopy time, radiation dose, technical success, and complications were analyzed. Statistical Analysis Used Descriptive statistics were analyzed using Microsoft Excel software. Results A total of 210 patients (420 sides) were analyzed. Double arterial supply on the same side was noted in 12 patients (5.7%). In 10 patients (4.7%), only a unilateral PA was identified. In two patients (0.9%), no PA could be identified. Frequencies of PA origins were calculated. Penile, rectal, and vesical anastomoses were identified with 79 (18.8%), 54 (12.9%), and 41 (9.8%) of PAs, respectively. Median skin radiation dose, procedure time, and fluoroscopy time were 505 mGy, 73 and 38 minutes, respectively. Complications occurred in nine patients (4.3%), none of them was major. Conclusions Knowledge of PA anatomy is essential when treating BPH by PAE for optimum results. There is no enough evidence to support routine use of preoperative computed tomography angiography and intraoperative cone-beam computed tomography as means of improving safety or efficacy.

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Inflammatory Complications of Prostatic Artery Embolization: an Up-to-Date Review

Noureldin

Taylor

Hindley

et al. 2023

Curr Bladder Dysfunct Rep

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Prostate Artery Embolization for Benign Prostate Hyperplasia Review: Patient Selection, Outcomes, and Technique

Cited by 8 publications

References 62 publications

Prostate Artery Embolization—Review of Indications, Patient Selection, Techniques and Results

Prostate Artery Embolization—Review of Indications, Patient Selection, Techniques and Results

Prostatic Artery Embolization for Benign Prostatic Hyperplasia: Anatomical Aspects and Radiation Considerations from a Case Series of 210 Patients

Inflammatory Complications of Prostatic Artery Embolization: an Up-to-Date Review

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