Initial Canadian Experience of Prostate Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: Midterm Outcomes

Abstract

Introduction: This study aimed to assess the midterm outcomes and safety of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH). Methods: A single-center, retrospective review of PAE performed for BPH was performed. Validated International Prostate Symptom Score (IPSS), quality of life (QoL) index, and International Index for Erectile Function (IIEF-5) questionnaires were completed at baseline and at least 12 months post-procedure. Prostate imaging was performed preprocedure as well as 3 months and 12 months post-procedure to assess prostate volume (PV). Uroflowmetry was also performed at baseline and 12 months post-procedure to assess urine flow rate (Qmax) and post-void residual (PVR) volume. Adverse events were graded according to Society of Interventional Radiology (SIR) guidelines. Results: Eighty male patients underwent the PAE procedure (mean age 69 years). Prostate volume decreased significantly from a mean volume 156 to 107 mL after 12 months post-procedure, commensurate with a mean reduction of 27.5% ( P < .05). Significant improvements were seen in IPSS (21.8 vs 10.5) and QoL (4.5 vs 2.0) from baseline to 12 months post-procedure ( P < .05). There was no significant change in IIEF-5 score. There was a significant reduction in PVR (202 vs 105 mL) and improvement in Qmax (5.9 vs 10.0 mL/s) between baseline and 12 months post-procedure ( P < .05). No major complications occurred; 4 minor complications occurred (SIR grade A or B). Conclusion: Prostate artery embolization achieved a clinically and statistically significant prostate volume reduction, symptom and QoL improvement, and enhanced uroflowmetry parameters in patients with BPH.

Comparison Between Radial and Femoral Artery Access for Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma

“…22,25 Third, the choice between RAA and FAA was left to the operator preference, which might have introduced bias due to selection of one approach over the other in light of patients' specificities, and limited the generalizability of our results. 33 Finally, we did not assess the differences in local pain at the puncture site between the two approaches. 34 In conclusion, the results of this study suggest that for patients with HCC, RAA is a safe approach that does not compromise the technical efficacy of TACE compared with FAA, in particular regarding the selectivity of the embolization.…”

“…22,25 Third, the choice between RAA and FAA was left to the operator preference, which might have introduced bias due to selection of one approach over the other in light of patients’ specificities, and limited the generalizability of our results. 33 Finally, we did not assess the differences in local pain at the puncture site between the two approaches. 34…”

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

“…There have been numerous retrospective or prospective case series from multiple international sites demonstrating the efficacy of PAE for the treatment of LUTS [ 3 , 40 , 61 , 62 , 63 , 64 , 65 ]. There were slight variations in methodology and follow up per study, but each demonstrated good clinical outcomes overall.…”

Prostatic Artery Embolization Versus Transurethral Resection of the Prostate: A Post Hoc Cost Analysis of a Randomized Controlled Clinical Trial

“…Prostatic artery embolization (PAE) has emerged as a minimally invasive therapy for symptomatic patients due to BPH and as an alternative to TURP, with similar clinical outcomes, fewer complications, and shorter recovery time [3][4][5][6][7][8][9]. The National Institute for Health and Care Excellence (NICE) supports the use of PAE for LUTS secondary to BPH, provided that standard arrangements are in place for clinical management, consent and audit [10].…”