Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates

Rampoldi, Antonio; Barbosa, Fernando Policarpo; Secco, Silvia; Migliorisi, Carmelo; Galfano, Antonio; Prestini, Giovanni; Harward, Sardis; Trapani, Dario; Brambillasca, Pietro; Vercelli, Ruggero; Solcia, Marco; Carnevale, Francisco César; Bocciardi, Aldo Massimo

doi:10.1007/s00270-017-1582-8

Cited by 54 publications

(25 citation statements)

References 27 publications

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“…We report good results when introducing PAE in the clinical setting, with interventional radiology and urology in close co-operation, in a Swedish county hospital. Clinically successful treatment in 84% without serious adverse events in this study is comparable with results reported in the literature [13][14][15], despite a selection-bias in our study with clinically unfavorable and anatomically difficult cases. Parallel to this study, a number of studies have been performed throughout the world.…”

Section: Discussionsupporting

confidence: 90%

“…The use of CBCT as an adjuvant technique provides useful information and helps treatment planning during PAE, to avoid non-target embolization [18], which may have played an important role in the fact that no major complications occurred in this study. The minor complications, one PAEsyndrome and one diarrhea, are similar to those reported in other studies [13][14][15][16]. PAE-syndrome is a burning sensation in the perineum, sometimes accompanied by discomfort or slight fever for a couple of days, affecting $ 9% of patients [13][14][15][16], and can be effectively alleviated with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs).…”

Section: Discussionsupporting

confidence: 83%

“…The minor complications, one PAEsyndrome and one diarrhea, are similar to those reported in other studies [13][14][15][16]. PAE-syndrome is a burning sensation in the perineum, sometimes accompanied by discomfort or slight fever for a couple of days, affecting $ 9% of patients [13][14][15][16], and can be effectively alleviated with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). Urinary infection may occur after PAE, as an indwelling catheter is used during the procedure.…”

Section: Discussionsupporting

confidence: 83%

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Introduction of prostate artery embolization (PAE) in Sweden

Lindgren

Bläckberg

2019

Scandinavian Journal of Urology

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Background: Transurethral resection of the prostate (TURP) is 'Gold Standard' treatment for moderateto-severe lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) with bladderoutlet obstruction (BOO). However, TURP is associated with a risk of complications, so minimally invasive methods have been developed. Prostate artery embolization (PAE) is a new minimally invasive procedure. This study reports the outcomes of PAE when introduced in a 'real life' clinical setting in a Swedish County hospital. Methods: A prospective, single-center, single-arm study in a consecutive vascular-anatomy 'all comers' population, eligible for TURP or adenomaenukleation, but unsuitable for this, treated with PAE from January 2015 to June 2018. Defined improvement of IPSS/QoL scores, or freedom from urinary catheter if previous urinary catheter-dependent, or clean intermittent catheterization (CIC) were considered as clinically successful treatments. PAE was performed until arterial stasis using the Perfected technique. Most patients were treated during a day-care procedure. Results: Of 37 treated men, bilateral PAEs were achieved in 32 patients, unilateral PAEs in four patients, and bilateral failure in one patient due to difficult vascular anatomy. Clinically successful treatment was achieved in 84%, without serious adverse events. Conclusions: PAE was introduced in Sweden, showing PAE as a novel and good minimally invasive alternative in treatment of symptomatic BPH, possible to perform as a day-care procedure.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 83%

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Introduction of prostate artery embolization (PAE) in Sweden

Lindgren

Bläckberg

2019

Scandinavian Journal of Urology

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“…Die allgemeine Effektivität und Sicherheit der PAE ist in prospektiven und retrospektiven Anwendungsbeobachtungen insbesondere aus Zentren, die dieses Verfahren inzwischen in der klinischen Routine anbieten, mittlerweile umfänglich beschrieben worden [57][58][59][60][61][62]. In einem aktuellen systematischen Review mit Metaanalyse von Malling et al ist die Wirksamkeit und Sicherheit der PAE anhand von kumulativ 1254 Patienten aus 13 Studien zusammengefasst und analysiert worden [63].…”

Section: Studienlageunclassified

Position Paper of the German Society for Interventional Radiology (DeGIR) on Prostatic Artery Embolization

Kovács¹,

Bücker

Grimm

et al. 2020

Rofo

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Background In recent years prostate artery embolization (PAE) evolved into a clinically established minimally invasive endovascular treatment option for lower urinary tract symptoms caused by benign prostate syndrome (BPS). Methods In this interdisciplinary position paper, initiated by the steering group for research of the German Society for Interventional Radiology (IR), the method of PAE is presented and discussed in the context of current evidence. Results PAE is a safe IR procedure for the treatment of BPS. In terms of symptom relief, measured with the IPSS (International Prostate Symptom Score), the PAE has comparable effect, similar to the historic gold standard, transurethral resection (TUR) of the prostate. With regard to reducing subvesical obstruction PAE is inferior to TUR, but does not limit subsequent surgery. Based on current evidence, PAE is recommended by the British National Institute for Health and Care Excellence as an alternative therapy. The feasibility under local anaesthesia and the preservation of sexual function are important arguments for patients in favour of interventional therapy. Patient selection and therapy concepts require close interdisciplinary collaboration between urologists and radiologists. Conclusion Effectiveness and safety of PAE for the treatment of BPS are proven. Further randomized trials should focus on long term outcome and help to identify most suitable indications for PAE. Key Points: Citation Format

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“…PAE is generally performed as an inpatient procedure; intravenous ciprofloxacin 400 mg should be administered within 1 hour before the procedure and continued for 7 days with 500 mg twice a day orally (30).…”

Section: Techniquementioning

confidence: 99%

State of the art of prostatic arterial embolization for benign prostatic hyperplasia

et al. 2018

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Prostatectomy via open surgery or transurethral resection of the prostate (TURP) is the standard treatment for benign prostatic hyperplasia (BPH). Several patients present contraindication for standard approach, individuals older than 60 years with urinary tract infection, strictures, post-operative pain, incontinence or urinary retention, sexual dysfunction, and blood loss are not good candidates for surgery. Prostatic artery embolization (PAE) is emerging as a viable method for patients unsuitable for surgery. In this article, we report results about technical and clinical success and safety of the procedure to define the current status.

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Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates

Abstract: PAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options.

Cited by 54 publications

References 27 publications

Introduction of prostate artery embolization (PAE) in Sweden

Introduction of prostate artery embolization (PAE) in Sweden

Position Paper of the German Society for Interventional Radiology (DeGIR) on Prostatic Artery Embolization

State of the art of prostatic arterial embolization for benign prostatic hyperplasia

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