skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Safety and Efficacy of Occlusion of Large Extra-Prostatic Anastomoses During Prostatic Artery Embolization for Symptomatic BPH

Abstract

IntroductionDuring PAE, preembolization angiography of the prostatic artery can show large extra-prostatic shunts, at high risk, if embolized, of rectal or penile necrosis. We report our experience with 11 consecutive patients who underwent protective embolization of large extra-prostatic shunts before successful PAE.Materials and MethodsWe treated 11 consecutive male patients (mean age 67 years), part of a series of 55 consecutive male patients referred for PAE to treat LUTS due to BPH, between December 2013 and January 2015. The procedure involved the exclusion of an extra-prostatic shunt originating from the PA, prior to complete bilateral PAE. We compared the safety and efficacy of the 11 shunt exclusions followed by embolization of the PA to the other 44 basic PAE. Clinical success was defined as a decrease of 25 % or eight points of IPSS, QoL <3 or a one-point decrease, and a Qmax improvement of 25 % or 2.5 mL/s.ResultsWe had a 100 % rate of occlusion of the anastomosis. Bilateral embolization of the PA was performed in all patients with no additional time of procedure (p = 0.18), but a significant increase of dose area product (p = 0.03). Distal (PErFecTED) embolization was possible in 64 %. There was no worsening of erectile dysfunction, no rectal or penile necrosis, no immediatemore » or late other clinical complications. Clinical success was 91 % (mean follow-up: 3.5 months), compared to 78 % for the entire PAE group.ConclusionPAE using the protection technique in case of large extra-prostatic shunts is as safe and effective as basic procedures and does not induce any additional time of procedure.« less

Authors:
; ;  [1];  [2];  [1];  [3]; ;  [1]
  1. Université Paris Descartes - Sorbonne - Paris – Cité, Faculté de Médecine (France)
  2. Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit (France)
  3. Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Department (France)
Publication Date:
OSTI Identifier:
22645447
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 9; Other Information: Copyright (c) 2016 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; BIOMEDICAL RADIOGRAPHY; BPH; BYPASSES; COMPARATIVE EVALUATIONS; HAZARDS; NECROSIS; PATIENTS; RECTUM; SAFETY; VASCULAR DISEASES

Citation Formats

Amouyal, Gregory, E-mail: gregamouyal@hotmail.com, Chague, Pierre, E-mail: pierre.chague@gmail.com, Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr, Pereira, Helena, E-mail: helena.pereira@aphp.fr, Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr, Dean, Carole, E-mail: carole.dean@aphp.fr, Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr, and Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr. Safety and Efficacy of Occlusion of Large Extra-Prostatic Anastomoses During Prostatic Artery Embolization for Symptomatic BPH. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1412-4.
Amouyal, Gregory, E-mail: gregamouyal@hotmail.com, Chague, Pierre, E-mail: pierre.chague@gmail.com, Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr, Pereira, Helena, E-mail: helena.pereira@aphp.fr, Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr, Dean, Carole, E-mail: carole.dean@aphp.fr, Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr, & Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr. Safety and Efficacy of Occlusion of Large Extra-Prostatic Anastomoses During Prostatic Artery Embolization for Symptomatic BPH. United States. doi:10.1007/S00270-016-1412-4.
Amouyal, Gregory, E-mail: gregamouyal@hotmail.com, Chague, Pierre, E-mail: pierre.chague@gmail.com, Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr, Pereira, Helena, E-mail: helena.pereira@aphp.fr, Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr, Dean, Carole, E-mail: carole.dean@aphp.fr, Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr, and Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr. Thu . "Safety and Efficacy of Occlusion of Large Extra-Prostatic Anastomoses During Prostatic Artery Embolization for Symptomatic BPH". United States. doi:10.1007/S00270-016-1412-4.
@article{osti_22645447,
title = {Safety and Efficacy of Occlusion of Large Extra-Prostatic Anastomoses During Prostatic Artery Embolization for Symptomatic BPH},
author = {Amouyal, Gregory, E-mail: gregamouyal@hotmail.com and Chague, Pierre, E-mail: pierre.chague@gmail.com and Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr and Pereira, Helena, E-mail: helena.pereira@aphp.fr and Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr and Dean, Carole, E-mail: carole.dean@aphp.fr and Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr and Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr},
abstractNote = {IntroductionDuring PAE, preembolization angiography of the prostatic artery can show large extra-prostatic shunts, at high risk, if embolized, of rectal or penile necrosis. We report our experience with 11 consecutive patients who underwent protective embolization of large extra-prostatic shunts before successful PAE.Materials and MethodsWe treated 11 consecutive male patients (mean age 67 years), part of a series of 55 consecutive male patients referred for PAE to treat LUTS due to BPH, between December 2013 and January 2015. The procedure involved the exclusion of an extra-prostatic shunt originating from the PA, prior to complete bilateral PAE. We compared the safety and efficacy of the 11 shunt exclusions followed by embolization of the PA to the other 44 basic PAE. Clinical success was defined as a decrease of 25 % or eight points of IPSS, QoL <3 or a one-point decrease, and a Qmax improvement of 25 % or 2.5 mL/s.ResultsWe had a 100 % rate of occlusion of the anastomosis. Bilateral embolization of the PA was performed in all patients with no additional time of procedure (p = 0.18), but a significant increase of dose area product (p = 0.03). Distal (PErFecTED) embolization was possible in 64 %. There was no worsening of erectile dysfunction, no rectal or penile necrosis, no immediate or late other clinical complications. Clinical success was 91 % (mean follow-up: 3.5 months), compared to 78 % for the entire PAE group.ConclusionPAE using the protection technique in case of large extra-prostatic shunts is as safe and effective as basic procedures and does not induce any additional time of procedure.},
doi = {10.1007/S00270-016-1412-4},
journal = {Cardiovascular and Interventional Radiology},
number = 9,
volume = 39,
place = {United States},
year = {Thu Sep 15 00:00:00 EDT 2016},
month = {Thu Sep 15 00:00:00 EDT 2016}
}