Society of Interventional Radiology Research Reporting Standards for Prostatic Artery Embolization

Uflacker, Andre; Haskal, Ziv J.; Baerlocher, Mark O.; Bhatia, Shivank; Carnevale, Francisco César; Dariushnia, Sean R.; Faintuch, Salomão; Gaba, Ron C.; Golzarian, Jafar; Midia, Mehran; Nikolic, Boris; Sapoval, M.; Walker, T. Gregory

doi:10.1016/j.jvir.2020.03.003

Cited by 4 publications

(3 citation statements)

References 94 publications

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“…One idea is to more extensively embolise the prostatic artery all the way back to its origin using coils or a liquid embolic (such as glue); however, we are concerned this could have the unintended consequence of making rPAE more difficult if revascularisation continued to occur through the recanalisation of the main prostatic artery, as the main prostatic artery could become difficult to access at rPAE due to the more extensive embolisation technique, although this is based on the assumption that more extensive embolisation at initial PAE would not change the revascularisation mechanisms. As noted by Uflacker et al in the Society of Interventional Radiologists' Standard of Practice, the optimal technique of PAE is ever evolving [23], and this particular aspect of technique would need exploring in a prospective study comparing the two technique.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Reperfusion and Clinical Findings in Repeat Prostate Artery Embolisation for Recurrent Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

Kearns

Boardman

Tapping

2020

Cardiovasc Intervent Radiol

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Purpose To present our experience of the patterns of revascularisation of the prostate and efficacy of repeat prostate artery embolisation (rPAE) in patients with recurrence of lower urinary tract symptoms. Materials and Methods We retrospectively analysed 12 patients who underwent rPAE at a single centre between November 2015 and March 2020. The patients had their intraprocedural angiography and cone beam CT images as well as their pre-procedural CT retrospectively reviewed to establish the patterns of revascularisation. Clinical followup occurred at a minimum of 3 months. Results 11/12 patients (91.6%) had significant international prostate symptom score (IPSS) reduction following rPAE with change in mean IPSS from 18.4 to 8.1 at 3 months (p \ 0.0001). Mean prostate volume was reduced by 41.6% (p = 0.03). 8/12 (75%) had a complete clinical success. 20/24 hemiprostates demonstrated revascularisation angiographically, of which 16 (80%) had prostatic arterial supply at rPAE by the main prostatic artery. Other mechanisms of revascularisation included supply from capsular prostatic artery branches and supply from other internal iliac pelvic branches. Unilateral embolisation at rPAE, where bilateral embolisation was not feasible (4/12), resulted in no difference in clinical outcomes compared with bilateral rPAE (p = 0.55). Conclusion We have found rPAE to be an effective treatment for recurrent lower urinary tract symptoms in patients who had good clinical response to initial PAE. The mechanisms of revascularisation are variable, but most patients that underwent rPAE had recanalisation of their main prostatic artery.

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Section: Discussionmentioning

confidence: 99%

Patterns of Reperfusion and Clinical Findings in Repeat Prostate Artery Embolisation for Recurrent Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

Kearns

Boardman

Tapping

2020

Cardiovasc Intervent Radiol

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“…Technical success was defined as bilateral embolization of the prostatic artery. Clinical success was defined as a 15-point improvement in IPSS and/or a 25% decrease from baseline, improved QoL score (< 3 points or decreased by 1 point from baseline), improved peak urinary flow (7 mL/s or > 2.5 mL), and/or medical therapy no longer being necessary [ 1 10 ]. The total procedure time was defined as the interval from time-out to access site hemostasis.…”

Section: Methodsmentioning

confidence: 99%

Prostatic Artery Embolization for Lower Urinary Tract Symptoms via Transradial Versus Transfemoral Artery Access: Single-Center Technical Outcomes

et al. 2022

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Objective To evaluate the safety and feasibility of prostatic artery embolization (PAE) via transradial access (TRA) compared with transfemoral access (TFA). Materials and Methods This retrospective study included 53 consecutive men with lower urinary tract symptoms (LUTS) who underwent PAE between September 2018 and September 2021. Thirty-one patients (mean age ± standard deviation: 70.6 ± 8.4 years) were treated with TFA, including 14 patients treated before adopting TRA. Since December 2019, TRA has also been attempted with the procedure’s selection criteria of patent carpal circulation and a height ≤ 172 cm, with 22 patients treated via TRA (69.1 ± 9.6 years). Parameters of technical success (defined as successful bilateral embolization), clinical success (defined as LUTS improvement), procedural time, radiation dose, and adverse events were compared between the two groups using the Fisher’s exact test, independent sample t test, Wilcoxon signed-rank test, or Mann-Whitney test. Results All patients received at least one-side PAE. Technical success of PAE was achieved in most patients (TRA, 21/22; TFA, 30/31; p > 0.999). No technical problem-related conversion from TRA to TFA occurred. The clinical success rate was 85% (11/13) in patients with TRA, and 89% (16/18) in patients with TFA for follow-up > 2 weeks post-PAE (median, 3 months) ( p > 0.999). The median procedure time was similar in both groups (TRA, 81 minutes vs. TFA, 94 minutes; p = 0.570). No significant dose differences were found between the TRA and TFA groups in the dose-area product (median Gycm 2 , 95 [range, 44–255] for TRA and 84 [34–255] for TFA; p = 0.678) or cumulative air kerma (median mGy, 609 [236–1584] for TRA and 634 [217–1594] for TFA; p = 0.551). No major adverse events occurred in either of the groups. Conclusion PAE via TRA is a safe and feasible method comparable to conventional TFA. It can be safely implemented by selecting patients with patent carpal circulation and adequate height.

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“…Primarily, surgery is useful to remove the main tumor during cancer treatment. However, this method is successful only if cancer has not metastasized because even a single infected cell can form another tumor. − Here, radiation therapy has managed to garner immense interest. It involves using ionizing radiation externally or internally to kill the cancer cells.…”

Section: Introductionmentioning

confidence: 99%

Review of the Mechanism of Nanocarriers and Technological Developments in the Field of Nanoparticles for Applications in Cancer Theragnostics

Shreyash

Sonker

Bajpai

et al. 2021

ACS Appl. Bio Mater.

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Cancer cannot be controlled by the usage of drugs alone, and thus, nanotechnology is an important technique that can provide the drug with an impetus to act more effectively. There is adequate availability of anticancer drugs that are classified as alkylating agents, hormones, or antimetabolites. Nanoparticle (NP) carriers increase the residence time of the drug, thereby enhancing the survival rate of the drug, which otherwise gets washed off owing to the small size of the drug particles by the excretory system. For example, for enhancing the circulation, a coating of nonfouling polymers like PEG and dextran is done. Famous drugs such as doxorubicin (DOX) are commonly encapsulated inside the nanocomposite. The various classes of nanoparticles are used to enhance drug delivery by aiding it to fight against the tumor. Targeted therapy aims to attack the cells with features common to the cancer cells while minimizing damage to the normal cell, and these therapies work in one in four ways. Some block the cancer cells from reproducing newer cells, others release toxic substances to kill the cancer cells, some stimulate the immune system to destroy the cancer cells, and some block the growth of more blood vessels around cancer cells, which starve the cells of the nutrients, which is needed for their growth. This review aims to testify the advancements nanotechnology has brought in cancer therapy, and its statements are supported with recent research findings and clinical trial results.

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Society of Interventional Radiology Research Reporting Standards for Prostatic Artery Embolization

Cited by 4 publications

References 94 publications

Patterns of Reperfusion and Clinical Findings in Repeat Prostate Artery Embolisation for Recurrent Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

Patterns of Reperfusion and Clinical Findings in Repeat Prostate Artery Embolisation for Recurrent Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

Prostatic Artery Embolization for Lower Urinary Tract Symptoms via Transradial Versus Transfemoral Artery Access: Single-Center Technical Outcomes

Review of the Mechanism of Nanocarriers and Technological Developments in the Field of Nanoparticles for Applications in Cancer Theragnostics

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