Prostatic Artery Embolization Using 100–300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: A Single-Center Outcomes Analysis with Medium-Term Follow-up

Ayyagari, Raj; Powell, Taylor; Staib, Lawrence H.; Chapiro, Julius; Raja, Anusha; Bhatia, Shivank; Chai, Toby C.; Schoenberger, Steven; Devito, Ralph

doi:10.1016/j.jvir.2019.08.005

Cited by 17 publications

(7 citation statements)

References 21 publications

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“…This study has shown statistically significant improvements in subjective (QoL, IPSS, IIEF, pain and satisfaction scores) and objective (Qmax, PVR, PV, prostatic infarct) outcomes in patients treated with PAE using PEGM, achieving a clinical success of 78.5%. These results are comparable to those previously published with PVA [5,6] and other types of microspheres [4, [19][20][21][22][23][24], where PAE improved BPH-related LUTS in patients.…”

Section: Discussionsupporting

confidence: 91%

Prostatic Artery Embolization (PAE) Using Polyethylene Glycol Microspheres: Safety and Efficacy in 81 Patients

Insausti¹,

Galbete

Lucas‐Cava

et al. 2022

Cardiovasc Intervent Radiol

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Purpose To evaluate the safety and efficacy of prostatic artery embolization (PAE) using polyethylene glycol microspheres (PEGM) in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH). Materials and methods This multicentric prospective study enrolled 81 patients who underwent PAE with 400 ± 75 µm PEGM (HydroPearl®, Terumo, Japan). Results from baseline and 1-, 3-, 6-, and 12-month follow-ups were assessed for subjective outcomes including International Prostate Symptoms Score (IPSS), Quality of life (QoL), and International Index of Erectile Function, and objective outcomes such as peak urinary flow (Qmax) and post-void residual volume (PVR). The visual analogue scale, satisfaction questionnaire, prostatic volume, and prostatic specific antigen levels were also evaluated. Complications were documented using the modified Clavien–Dindo classification. Results Technical success was obtained in all patients. Clinical success was achieved in 78.5% of patients. Before PAE, 54.3% of patients had an indwelling catheter which was removed in 75% of them after procedure. A statistically significant decrease was observed in IPSS and QoL from baseline to 12 months (20.14 vs 5.89; 4.8 vs 0.63, P < .01), respectively. Objective outcomes also showed a statistically significant improvement in Qmax (+ 114.9%; P < .01), achieving a maximum urinary flow of 14.2 mL/sec, and PVR (decrease 58%; P < .05) at 12 months. Minor complications (Clavien–Dindo grades I–II) occurred in 13.6% of patients, without major complications observed. Conclusion PAE with PEGM is safe and effective treatment in patients with symptomatic BPH, with a significant improvement in both subjective and objective outcomes.

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Section: Discussionsupporting

confidence: 91%

Prostatic Artery Embolization (PAE) Using Polyethylene Glycol Microspheres: Safety and Efficacy in 81 Patients

Insausti¹,

Galbete

Lucas‐Cava

et al. 2022

Cardiovasc Intervent Radiol

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“…Therefore, the gradual reduction of PV alleviates LUTS. PAE achieves this goal through embolization of the main prostatic artery (22). However, HoLEP surgery is performed on prostate tissue with enucleation hyperplasia through direct urethral laser, with better and more accurate effect.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies

2022

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Background There are many ways to treat prostatic hyperplasia; these are currently more inclined to minimally invasive treatment. We mainly compared the differences between two treatment methods， ultrasound-guided transperineal laser ablation (US-TPLA) and prostatic artery embolization (PAE). Purpose To evaluate the efficacy and safety of US-TPLA and PAE in the treatment of benign prostatic hyperplasia (BPH). Material and Methods The clinical information for 40 patients with BPH admitted to our hospital between June 2018 and January 2021 were retrospectively analyzed. The changes in International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume (PV), and the incidence of complications were compared between groups. Results The IPSS ( P < 0.001; P < 0.001), QoL ( P < 0.001; P < 0.001), Qmax ( P < 0.001; P < 0.001), PVR ( P < 0.001; P < 0.001), and PV ( P < 0.001; P < 0.001) at three and six months after US-TPLA and PAE improved with respect to those before surgery. There was no significant difference in IPSS ( P = 0.235; P = 0.151), QoL ( P = 0.527; P = 0.294), Qmax ( P = 0.776; P = 0.420), PVR ( P = 0.745; P = 0.607), and PV ( P = 0.527; P = 0.573) between the groups at three and six months after surgery. No serious complications occurred in either group. Conclusion US-TPLA and PAE seem to have a similar short-term efficacy. The efficacy of the two procedures is comparable, and neither is associated with serious complications. US-TPLA and PAE are both effective complementary measures for the treatment of BPH.

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“…Wires such as 0.014-in shapeable guidewire (Fathom; Boston Scientific Corporation, Marlborough, MA) and the 0.016-in double-angle Glidewire GT (Terumo Interventional Systems, Somerset, NJ) are widely used starter choices. 15,18,19 For larger vessels, 0.016-in shapeable guidewire (Fathom, Boston Scientific Corporation) may be utilized. 19,20 Some of the most technically challenging arteries are type 1 prostatic arteries (shared origin with the SVA in a common trunk), primarily associated with atherosclerosis of the anterior division of the IIA.…”

Section: Catheter and Wire Choice For Paementioning

confidence: 99%

Section: Catheter and Wire Choice For Paementioning

confidence: 99%

Prostatic Artery Embolization: Technical Pearls

Bhatia

Maini

Bhatia

2022

Semin intervent Radiol

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Benign prostatic hyperplasia (BPH) is a condition that primarily affects men between the fourth and seventh decades of life, occurring due to enlargement of the prostate which subsequently causes compression of the prostatic urethra causing chronic obstruction of the urinary outflow tract. BPH can cause significant quality-of-life issues such as urinary hesitancy, intermittency, decreased urinary stream, a sensation of incomplete emptying, dysuria, urinary retention, hematuria, and nocturia. Several medical and surgical treatment modalities are available for the treatment of lower urinary tract symptoms and other BPH-related sequela; however, increasingly prostate artery embolization is being utilized in this patient population. Technical demands for this procedure in this population can be significant. This article describes the optimal techniques, tricks, and advanced imaging techniques that can be used to achieve desired technical outcomes.

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Prostatic Artery Embolization Using 100–300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: A Single-Center Outcomes Analysis with Medium-Term Follow-up

Cited by 17 publications

References 21 publications

Prostatic Artery Embolization (PAE) Using Polyethylene Glycol Microspheres: Safety and Efficacy in 81 Patients

Prostatic Artery Embolization (PAE) Using Polyethylene Glycol Microspheres: Safety and Efficacy in 81 Patients

Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies

Prostatic Artery Embolization: Technical Pearls

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