nach oben

CardioVascular and Interventional Radiology

Erschienen in:

01.03.2016 | Clinical Investigation

Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study

verfasst von: Gregory Amouyal, Nicolas Thiounn, Olivier Pellerin, Lin Yen-Ting, Costantino Del Giudice, Carole Dean, Helena Pereira, Gilles Chatellier, Marc Sapoval

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

Prostatic artery embolization (PAE) has been performed for a few years, but there is no report on PAE using the PErFecTED technique outside from the team that initiated this approach.

Objective

This single-center retrospective open label study reports our experience and clinical results on patients suffering from symptomatic BPH, who underwent PAE aiming at using the PErFecTED technique.

Materials and Methods

We treated 32 consecutive patients, mean age 65 (52–84 years old) between December 2013 and January 2015. Patients were referred for PAE after failure of medical treatment and refusal or contra-indication to surgery. They were treated using the PErFecTED technique, when feasible, with 300–500 µm calibrated microspheres (two-night hospital stay or outpatient procedure). Follow-up was performed at 3, 6, and 12 months.

Results

We had a 100 % immediate technical success of embolization (68 % of feasibility of the PErFecTED technique) with no immediate complications. After a mean follow-up of 7.7 months, we observed a 78 % rate of clinical success. Mean IPSS decreased from 15.3 to 4.2 (p = .03), mean QoL from 5.4 to 2 (p = .03), mean Qmax increased from 9.2 to 19.2 (p = .25), mean prostatic volume decreased from 91 to 62 (p = .009) mL. There was no retrograde ejaculation and no major complication.

Conclusion

PAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons.

Taylor BC, Wilt TJ, Fink HA, Lambert LC, Marshall LM, Hoffman AR, et al. Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology. 2006;68(4):804–9.CrossRefPubMed

Robert G, Descazeaud A, Delongchamps NB, Cornu JN, Azzouzi AR, Haillot O, et al. Benign prostatic hyperplasia medical treatment: systematic review of the literature by the CTMH/AFU. Prog Urol. 2012;22(1):7–12.CrossRefPubMed

Roehrborn CG, Siami P, Barkin J, Damiao R, Major-Walker K, Nandy I, et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010;57(1):123–31.CrossRefPubMed

Antunes AA, Carnevale FC, da Motta Leal Filho JM, Yoshinaga EM, Cerri LM, Baroni RH, et al. Clinical, laboratorial, and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study. Cardiovasc Interv Radiol. 2013;36(4):978–86.CrossRef

Bagla S, Martin CP, van Breda A, Sheridan MJ, Sterling KM, Papadouris D, et al. Early results from a United States trial of prostatic artery embolization in the treatment of benign prostatic hyperplasia. J Vasc Interv Radiol. 2014;25(1):47–52.CrossRefPubMed

Carnevale FC, Antunes AA. Prostatic artery embolization for enlarged prostates due to benign prostatic hyperplasia. How I do it. Cardiovasc Inter Radiol. 2013;36(6):1452–63.CrossRef

Carnevale FC, da Motta-Leal-Filho JM, Antunes AA, Baroni RH, Marcelino AS, Cerri LM, et al. Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol. 2013;24(4):535–42.CrossRefPubMed

Gao YA, Huang Y, Zhang R, Yang YD, Zhang Q, Hou M, et al. Benign prostatic hyperplasia: prostatic arterial embolization versus transurethral resection of the prostate—a prospective, randomized, and controlled clinical trial. Radiology. 2014;270(3):920–8.CrossRefPubMed

Grosso M, Balderi A, Arno M, Sortino D, Antonietti A, Pedrazzini F, et al. Prostatic artery embolization in benign prostatic hyperplasia: preliminary results in 13 patients. Radiol Med. 2015;120(4):361–8.CrossRefPubMed

10.

Kurbatov D, Russo GI, Lepetukhin A, Dubsky S, Sitkin I, Morgia G, et al. Prostatic artery embolization for prostate volume greater than 80 cm3: results from a single-center prospective study. Urology. 2014;84(2):400–4.CrossRefPubMed

11.

Pisco JM, Rio Tinto H, Campos Pinheiro L, Bilhim T, Duarte M, Fernandes L, et al. Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol. 2013;23(9):2561–72.CrossRefPubMed

12.

Carnevale FC, Moreira AM, Antunes AA. The “PErFecTED Technique”: proximal embolization first, then embolize distal for benign prostatic hyperplasia. Cardiovasc Interv Radiol. 2014;37:1602–5.CrossRef

13.

Ap J, Bilhim T, Duarte M, Rio Tinto H, Fernandes L, Martins Pisco J. Patient selection and counseling before prostatic arterial embolization. Tech Vasc Interv Radiol. 2012;15(4):270–5.CrossRef

14.

Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14(9 Pt 2):S199–202.CrossRefPubMed

15.

de Assis AM, Moreira AM, de Paula Rodrigues VC, Yoshinaga EM, Antunes AA, Harward SH, et al. Prostatic artery embolization for treatment of benign prostatic hyperplasia in patients with prostates >90 g: a prospective single-center study. J Vasc Interv Radiol. 2015;26(1):87–93.CrossRefPubMed

16.

Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol. 2008;180(1):246–9.CrossRefPubMed

17.

Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N, et al. Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol. 2007;177(4):1419–22.CrossRefPubMed

18.

Lourenco T, Armstrong N, N’Dow J, Nabi G, Deverill M, Pickard R, et al. (2008) Systematic review and economic modelling of effectiveness and cost utility of surgical treatments for men with benign prostatic enlargement. Health Technol Assess 12(35):iii, ix–x, 1–146, 69–515

19.

Westenberg A, Gilling P, Kennett K, Frampton C, Fraundorfer M. Holmium laser resection of the prostate versus transurethral resection of the prostate: results of a randomized trial with 4-year minimum long-term followup. J Urol. 2004;172(2):616–9.CrossRefPubMed

20.

Wilson LC, Gilling PJ, Williams A, Kennett KM, Frampton CM, Westenberg AM, et al. A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years. Eur Urol. 2006;50(3):569–73.CrossRefPubMed

21.

Tan A, Liao C, Mo Z, Cao Y. Meta-analysis of holmium laser enucleation versus transurethral resection of the prostate for symptomatic prostatic obstruction. Br J Surg. 2007;94(10):1201–8.CrossRefPubMed

22.

Pisco JM, Pinheiro LC, Bilhim T, Duarte M, Mendes JR, Oliveira AG. Prostatic arterial embolization to treat benign prostatic hyperplasia. J Vasc Interv Radiol. 2011;22(1):11–9 quiz 20.CrossRefPubMed

23.

Moreira AM, Marques CF, Antunes AA, Nahas CS, Nahas SC, de Gregorio Ariza MA, et al. Transient ischemic rectitis as a potential complication after prostatic artery embolization: case report and review of the literature. Cardiovasc Inter Radiol. 2013;36(6):1690–4.CrossRef

24.

Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, et al. EAU Guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including Benign prostatic obstruction. Eur Urol. 2015;67(6):1099–109.CrossRefPubMed

Titel: Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study
verfasst von: Gregory Amouyal
Nicolas Thiounn
Olivier Pellerin
Lin Yen-Ting
Costantino Del Giudice
Carole Dean
Helena Pereira
Gilles Chatellier
Marc Sapoval
Publikationsdatum: 01.03.2016
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 3/2016
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-015-1267-0

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study