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Title: Radiodermitis After Prostatic Artery Embolization: Case Report and Review of the Literature

Abstract

Prostate artery embolization (PAE) is a technically demanding new treatment option for benign prostatic hyperplasia. We present a case of radiation-induced dermitis in a 63-year-old patient after a technically successful PAE, due to high radiation exposure (KAP: 8,023,949 mGy cm{sup 2}) and long fluoroscopy time (72 min). Anatomical and technical aspects are discussed, as well as recommendations to decrease radiation exposure in these procedures.

Authors:
 [1];  [2]; ;  [1];  [2];  [1]
  1. Universidad de Zaragoza, Group of Research in Minimally Invasive Techniques (GITMI), Facultad de Veterinaria (Spain)
  2. University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil)
Publication Date:
OSTI Identifier:
22469945
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 3; Conference: CIRSE 2015: Cardiovascular and Interventional Radiological Society of Europe congress, Lisbon (Portugal), 26-30 Sep 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; FLUOROSCOPY; PATIENTS; PROSTATE; RECOMMENDATIONS; REVIEWS; VASCULAR DISEASES

Citation Formats

Laborda, Alicia, E-mail: alaborda@unizar.es, Assis, Andre Moreira De, E-mail: andre.maa@gmail.com, Ioakeim, Ignatios, E-mail: ignacio.ioakim@hotmail.es, Sánchez-Ballestín, María, E-mail: mirisanba@gmail.com, Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br, and Gregorio, Miguel Angel De, E-mail: mgregori@unizar.es. Radiodermitis After Prostatic Artery Embolization: Case Report and Review of the Literature. United States: N. p., 2015. Web. doi:10.1007/S00270-015-1083-6.
Laborda, Alicia, E-mail: alaborda@unizar.es, Assis, Andre Moreira De, E-mail: andre.maa@gmail.com, Ioakeim, Ignatios, E-mail: ignacio.ioakim@hotmail.es, Sánchez-Ballestín, María, E-mail: mirisanba@gmail.com, Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br, & Gregorio, Miguel Angel De, E-mail: mgregori@unizar.es. Radiodermitis After Prostatic Artery Embolization: Case Report and Review of the Literature. United States. doi:10.1007/S00270-015-1083-6.
Laborda, Alicia, E-mail: alaborda@unizar.es, Assis, Andre Moreira De, E-mail: andre.maa@gmail.com, Ioakeim, Ignatios, E-mail: ignacio.ioakim@hotmail.es, Sánchez-Ballestín, María, E-mail: mirisanba@gmail.com, Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br, and Gregorio, Miguel Angel De, E-mail: mgregori@unizar.es. Mon . "Radiodermitis After Prostatic Artery Embolization: Case Report and Review of the Literature". United States. doi:10.1007/S00270-015-1083-6.
@article{osti_22469945,
title = {Radiodermitis After Prostatic Artery Embolization: Case Report and Review of the Literature},
author = {Laborda, Alicia, E-mail: alaborda@unizar.es and Assis, Andre Moreira De, E-mail: andre.maa@gmail.com and Ioakeim, Ignatios, E-mail: ignacio.ioakim@hotmail.es and Sánchez-Ballestín, María, E-mail: mirisanba@gmail.com and Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br and Gregorio, Miguel Angel De, E-mail: mgregori@unizar.es},
abstractNote = {Prostate artery embolization (PAE) is a technically demanding new treatment option for benign prostatic hyperplasia. We present a case of radiation-induced dermitis in a 63-year-old patient after a technically successful PAE, due to high radiation exposure (KAP: 8,023,949 mGy cm{sup 2}) and long fluoroscopy time (72 min). Anatomical and technical aspects are discussed, as well as recommendations to decrease radiation exposure in these procedures.},
doi = {10.1007/S00270-015-1083-6},
journal = {Cardiovascular and Interventional Radiology},
number = 3,
volume = 38,
place = {United States},
year = {Mon Jun 15 00:00:00 EDT 2015},
month = {Mon Jun 15 00:00:00 EDT 2015}
}
  • Prostatic artery embolization (PAE) is an alternative treatment for benign prostatic hyperplasia. Complications are primarily related to non-target embolization. We report a case of ischemic rectitis in a 76-year-old man with significant lower urinary tract symptoms due to benign prostatic hyperplasia, probably related to nontarget embolization. Magnetic resonance imaging revealed an 85.5-g prostate and urodynamic studies confirmed Inferior vesical obstruction. PAE was performed bilaterally. During the first 3 days of follow-up, a small amount of blood mixed in the stool was observed. Colonoscopy identified rectal ulcers at day 4, which had then disappeared by day 16 post PAE without treatment.more » PAE is a safe, effective procedure with a low complication rate, but interventionalists should be aware of the risk of rectal nontarget embolization.« less
  • Benign prostate obstruction with associated lower urinary tract symptoms is a common diagnosis with multiple minimally invasive treatment options available. Herein, the authors describe three patients who failed prior different urological interventions who underwent prostate artery embolization with a subsequent improvement in symptoms. The positive response suggests that embolization may be an effective treatment alternative in this subset of patients.
  • PurposeWe report three cases of spontaneous prostatic tissue elimination through the urethra while voiding following technically successful prostatic artery embolization (PAE) as a treatment for lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH).MethodsAll patients were embolized with 100- to 300-μm microspheres alone or in combination with 300- to 500-μm microspheres.ResultsDuring follow-up prior to eliminating the tissue fragments, the three patients all presented with intermittent periods of LUTS improvement and aggravation. After expelling the prostatic tissue between 1 and 5 months of follow-up, significant improvements in LUTS and urodynamic parameters were observed in all patients.ConclusionsUrethral obstruction after PAEmore » caused by sloughing prostate tissue is a potential complication of the procedure and should be considered in patients with recurrent LUTS in order to avoid inappropriate management.« less
  • A 75-year-old man with arterial hypertension, coronary artery disease, and myocardial infarction was referred to our service because of an asymptomatic hypogastric artery aneurysm (HAA) detected by a routine compued tomography (CT) scan. As shown on the angio-CT the maximum transverse diameter (m.t.d.) of the HAA was 47 mm. There were no symptoms of distal embolization or compression on the pelvic structures. We performed the successful complete thrombosis of the aneurysm using vascular plugs via a controlateral femoral approach. The control angiogram was satisfactory and there were no intraoperative complications. A CT-angiography done 4 months after the procedure showed nomore » signs of refilling of the aneurysm sac. This case illustrates some possible advantages of vascular plugs in the treatment of isolated HAA.« less
  • PurposeTo summarize current evidence on outcomes and complications of prostatic artery embolization as a treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia.Methods and MaterialsA database search of MEDLINE, Embase, Web of Science, and Cochrane Library was performed for published literature up to August 2015 concerning PAE in the treatment of BPH. Inclusion and exclusion criteria were applied by two independent reviewers, and disagreements were resolved by consensus. Peer-reviewed studies concerning PAE with BPH with a sample size >10 and at least one measured parameter were included.ResultsThe search yielded 193 articles, of which ten studies representingmore » 788 patients, with a mean age of 66.97 years, were included. Patients had LUTS ranging from moderate to severe. At 6 months following procedure, PV, PVR, Qmax, IPSS, and QoL were significantly improved (P < 0.05), while for PSA there was no significant change. At 12 and 24 months, PV, PSA, PVR, Qmax, IPSS, and QoL were significantly improved (P < 0.05). IIEF was unchanged at 6 and 12 months but was significantly reduced at 24 months.ConclusionThis suggests that PAE is effective in treating LUTS in the short and intermediate term.« less