Prostatic artery embolization using three-dimensional cone-beam computed tomography

Cadour, Farah; Tradi, Farouk; Habert, Paul; Scemama, Ugo; Vidal, Vincent; Jacquier, Alexis; Bartoli, Jean-Michel; Moulin, G.; Bessayah, A.

doi:10.1016/j.diii.2020.05.002

Cited by 26 publications

(11 citation statements)

References 27 publications

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“…The radiation dose was usually decreased after approximately 10 cases were performed by interventional radiologists. In addition, the use of cone-beam CT (CBCT) reduces the risk of nontargeted embolism[ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis

Wang¹,

Chai²,

Huang³

et al. 2022

World J Clin Cases

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BACKGROUND Prostate artery embolization (PAE) is a promising minimally invasive therapy that improves lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). Transurethral resection of the prostate (TURP) is the gold standard therapy for LUTS/BPH. AIM To evaluate the efficacy and safety of PAE vs TURP on LUTS related to BPH. METHODS A literature review was performed to identify all published articles on PAE vs TURP for LUTS/BPH. Sources included PubMed, Embase, Cochrane library databases, and Chinese databases before June 2022. A systematic review and meta-analysis were conducted. Outcome measurements were combined by calculating the mean difference with a 95% confidence interval. Statistical analysis was carried out using Review Manager 5.3. RESULTS Eleven studies involving 1070 participants were included. Compared with the TURP group, the PAE group had a similar effect on the International Index of Erectile Function (IPSS) score, Peak urinary flow rate (Qmax), postvoid residual volume (PVR), Prostate volume (PV), prostatic specific antigen (PSA), The International Index of Erectile Function short form (IIEF-5) scores, and erectile dysfunction during 24 mo follow-up. Lower quality of life (QoL) score, lower rate of retrograde ejaculation and shorter hospital stay in the PAE group. There was no participant death in either group. A higher proportion of haematuria, urinary incontinence and urinary stricture was identified in the TURP group. CONCLUSION PAE may be an appropriate option for elderly patients, patients who are not candidates for surgery, and patients who do not want to risk the potential adverse effects of TURP. Studies with large cases and long follow-up time are needed to validate results.

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Section: Discussionmentioning

confidence: 99%

Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis

Wang¹,

Chai²,

Huang³

et al. 2022

World J Clin Cases

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“…CBCT has been increasingly adopted and recommended during IR procedures, allowing a precise assessment of complex vascular anatomy in 3D with a single injection of contrast medium in a selectively targeted artery. Its bene ts include high spatial resolution combined with an intra-arterial injection of a smaller volume of contrast compared to CT. Its value during PAE compared to DSA has already been demonstrated [10][11][12][13][14][15]. CBCT provided information that impacted treatment in 46% of PAE patients by allowing identi cation of potential sites of non-target embolization [10].…”

Section: Imaging Optionsmentioning

confidence: 99%

“…Although the use of cone-beam computed tomography (CBCT) has recently been encouraged to better understand the pelvic vascular anatomy [10][11][12][13][14][15], PAE remains technically challenging, typically resulting in long procedure and uoroscopy times, and high radiation dose due to the need for multiple oblique digital subtraction angiographies (DSA) and magni ed views, with signi cant variability between centers (median DAP ranging from 33.2 to 863.4 Gy•cm2 between individual studies) [16][17][18][19][20][21]. In this context, a re ned technique is crucial for technical and clinical success.…”

Section: Introductionmentioning

confidence: 99%

Advanced Image Guidance For Prostatic Artery Embolization – A Multicenter Technical Note

Carnevale

McClure

Cadour

et al. 2021

Preprint

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Prostatic artery embolization (PAE) is associated with patients’ quality of life improvements and limited side effects compared to surgery. However, this procedure remains technically challenging due to complex vasculature, anatomical variations and small arteries, inducing long procedure times and high radiation exposure levels both to patients and medical staff. Moreover, the risk of non-target embolization can lead to relevant complications. In this context, advanced imaging can constitute a solid ally to address these challenges and deliver good clinical outcomes at acceptable radiation levels. This technical note aims to share the consolidated experience of four institutions detailing their optimized workflow using advanced image guidance, discussing variants, and sharing their best practices.

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“…CBCT has been increasingly adopted and recommended during IR procedures, allowing a precise assessment of complex vascular anatomy in 3D with a single injection of contrast medium in a selectively targeted artery. Its benefits include high spatial resolution combined with an intra-arterial injection of a smaller volume of contrast compared to CT. Its value during PAE compared to preoperative CT and to DSA has already been demonstrated (Bagla et al 2013;Wang et al 2017;Rocha et al 2020;Cadour et al 2020;Bagla and Sterling 2014;Schnapauff et al 2020;Desai et al 2018). Compared to DSA, CBCT provided information that impacted treatment in 46% of PAE patients by allowing identification of potential sites of nontarget embolization (Bagla et al 2013).…”

Section: Intraprocedural Imaging -General Guidelinesmentioning

confidence: 99%

“…Although the use of cone-beam computed tomography (CBCT) has recently been encouraged to better understand the pelvic vascular anatomy (Bagla et al 2013;Wang et al 2017;Rocha et al 2020;Cadour et al 2020;Bagla and Sterling 2014;Schnapauff et al 2020), PAE remains technically challenging, typically resulting in long procedure and fluoroscopy times, and high radiation dose due to the need for multiple oblique digital subtraction angiographies (DSA) and magnified views, with significant variability between centers (median DAP ranging from 33.2 to 863.4 Gy•cm2 between individual studies) (Laborda et al 2015;Garzon et al 2016;Andrade et al 2017;Maclean et al 2017;Tanaka et al 2017;Zumstein et al 2020). In this context, a refined technique is crucial for technical and clinical success.…”

Section: Introductionmentioning

confidence: 99%

Advanced image guidance for prostatic artery embolization – a multicenter technical note

et al. 2021

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Background Prostatic artery embolization (PAE) is associated with patients’ quality of life improvements and limited side effects compared to surgery. However, this procedure remains technically challenging due to complex vasculature, anatomical variations and small arteries, inducing long procedure times and high radiation exposure levels both to patients and medical staff. Moreover, the risk of non-target embolization can lead to relevant complications. In this context, advanced imaging can constitute a solid ally to address these challenges and deliver good clinical outcomes at acceptable radiation levels. Main text This technical note aims to share the consolidated experience of four institutions detailing their optimized workflow using advanced image guidance, discussing variants, and sharing their best practices to reach a consensus standardized imaging workflow for PAE procedure, as well as pre and post-operative imaging. Conclusions This technical note puts forth a consensus optimized imaging workflow and best practices, with the hope of helping drive adoption of the procedure, deliver good clinical outcomes, and minimize radiation dose levels and contrast media injections while making PAE procedures shorter and safer.

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Prostatic artery embolization using three-dimensional cone-beam computed tomography

Cited by 26 publications

References 27 publications

Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis

Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis

Advanced Image Guidance For Prostatic Artery Embolization – A Multicenter Technical Note

Advanced image guidance for prostatic artery embolization – a multicenter technical note

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