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Comparison of Clinical Outcomes of Prostatic Artery Embolization with 50-μm Plus 100-μm Polyvinyl Alcohol (PVA) Particles versus 100-μm PVA Particles Alone: A Prospective Randomized Trial.
J Vasc Interv Radiol. 2018 12; 29(12):1694-1702.JV

Abstract

PURPOSE

To evaluate the safety and efficacy of prostatic artery embolization (PAE) using the combination of 50-μm and 100-μm polyvinyl alcohol (PVA) particles versus 100-μm PVA particles alone in the treatment of patients with symptomatic benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

Over a 5-year period, 120 patients treated with PAE for lower urinary tract symptoms (LUTS) secondary to BPH were randomized to undergo embolization with 50-μm plus 100-μm PVA particles (group A) or 100-μm PVA particles alone (group B). Mean follow-up time was 34 months (range, 12-57 mo). There were no differences between groups regarding baseline data. Primary outcome measurements included change in International Prostate Symptom Score (IPSS) and incidence of adverse events. Secondary outcome measurements included procedure-associated pain, prostate ischemia measured on magnetic resonance (MR) imaging 1 week after PAE, and changes over time in quality of life (QOL) questionnaire, peak urinary flow rate (Qmax), postvoid residual (PVR) volume, prostate volume (PV), prostate-specific antigen (PSA) level, and International Index of Erectile Function (IIEF) were evaluated. Recurrence of LUTS following PAE was defined as relief of LUTS temporally but increased IPSS ≥ 8 or QOL score ≥ 3 or decrease in Qmax to < 7 mL/s.

RESULTS

Mean follow-up periods were 35 months ± 22 in group A and 33 months ± 25 in group B (P = .629). No differences between groups regarding procedural details, pain scores, or adverse events were noted (P > .05). At 24 month of follow-up, patients in group A had a greater decrease in mean IPSS (18.7 ± 12.5 vs 14.8 ± 13.5), QOL score (3.7 ± 1.5 vs 2.4 ± 1.8), Qmax (10.5 mL ± 9.5 vs 6.8 mL ± 5.0), PVR (92.0 mL ± 75.0 vs 60.0 mL ± 55.0), and PV (37.0 mL ± 19.5 vs 25.5 mL ± 15.0) compared with patients in group B (P < .05 for all). Mean ratios of prostate ischemic volume at 1 week after PAE were 70% ± 20 in group A and 41% ± 25 in group B (P = .021); mean PSA levels at 24 hour after PAE were 92.5 ng/mL ± 55.0 in group A and 77.5 ng/mL ± 45.0 in group B (P = .031); LUTS recurrence rates were 3.6% in group A and 14.6% in group B (P = .024). The mean IIEF-5 was not significantly different from baseline in either group.

CONCLUSIONS

PAE with 50-μm plus 100-μm PVA particles resulted in greater improvement in clinical and imaging outcomes and no significant differences in adverse events compared with 100-μm PVA particles alone.

Authors+Show Affiliations

Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China. Electronic address: wangmq@vip.sina.com.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China.Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30297313

Citation

Wang, Mao Qiang, et al. "Comparison of Clinical Outcomes of Prostatic Artery Embolization With 50-μm Plus 100-μm Polyvinyl Alcohol (PVA) Particles Versus 100-μm PVA Particles Alone: a Prospective Randomized Trial." Journal of Vascular and Interventional Radiology : JVIR, vol. 29, no. 12, 2018, pp. 1694-1702.
Wang MQ, Zhang JL, Xin HN, et al. Comparison of Clinical Outcomes of Prostatic Artery Embolization with 50-μm Plus 100-μm Polyvinyl Alcohol (PVA) Particles versus 100-μm PVA Particles Alone: A Prospective Randomized Trial. J Vasc Interv Radiol. 2018;29(12):1694-1702.
Wang, M. Q., Zhang, J. L., Xin, H. N., Yuan, K., Yan, J., Wang, Y., Zhang, G. D., & Fu, J. X. (2018). Comparison of Clinical Outcomes of Prostatic Artery Embolization with 50-μm Plus 100-μm Polyvinyl Alcohol (PVA) Particles versus 100-μm PVA Particles Alone: A Prospective Randomized Trial. Journal of Vascular and Interventional Radiology : JVIR, 29(12), 1694-1702. https://doi.org/10.1016/j.jvir.2018.06.019
Wang MQ, et al. Comparison of Clinical Outcomes of Prostatic Artery Embolization With 50-μm Plus 100-μm Polyvinyl Alcohol (PVA) Particles Versus 100-μm PVA Particles Alone: a Prospective Randomized Trial. J Vasc Interv Radiol. 2018;29(12):1694-1702. PubMed PMID: 30297313.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Clinical Outcomes of Prostatic Artery Embolization with 50-μm Plus 100-μm Polyvinyl Alcohol (PVA) Particles versus 100-μm PVA Particles Alone: A Prospective Randomized Trial. AU - Wang,Mao Qiang, AU - Zhang,Jin Long, AU - Xin,Hai Nan, AU - Yuan,Kai, AU - Yan,Jieyu, AU - Wang,Yan, AU - Zhang,Guo Dong, AU - Fu,Jin Xin, Y1 - 2018/10/05/ PY - 2018/05/16/received PY - 2018/06/24/revised PY - 2018/06/26/accepted PY - 2018/10/10/pubmed PY - 2019/4/10/medline PY - 2018/10/10/entrez SP - 1694 EP - 1702 JF - Journal of vascular and interventional radiology : JVIR JO - J Vasc Interv Radiol VL - 29 IS - 12 N2 - PURPOSE: To evaluate the safety and efficacy of prostatic artery embolization (PAE) using the combination of 50-μm and 100-μm polyvinyl alcohol (PVA) particles versus 100-μm PVA particles alone in the treatment of patients with symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Over a 5-year period, 120 patients treated with PAE for lower urinary tract symptoms (LUTS) secondary to BPH were randomized to undergo embolization with 50-μm plus 100-μm PVA particles (group A) or 100-μm PVA particles alone (group B). Mean follow-up time was 34 months (range, 12-57 mo). There were no differences between groups regarding baseline data. Primary outcome measurements included change in International Prostate Symptom Score (IPSS) and incidence of adverse events. Secondary outcome measurements included procedure-associated pain, prostate ischemia measured on magnetic resonance (MR) imaging 1 week after PAE, and changes over time in quality of life (QOL) questionnaire, peak urinary flow rate (Qmax), postvoid residual (PVR) volume, prostate volume (PV), prostate-specific antigen (PSA) level, and International Index of Erectile Function (IIEF) were evaluated. Recurrence of LUTS following PAE was defined as relief of LUTS temporally but increased IPSS ≥ 8 or QOL score ≥ 3 or decrease in Qmax to < 7 mL/s. RESULTS: Mean follow-up periods were 35 months ± 22 in group A and 33 months ± 25 in group B (P = .629). No differences between groups regarding procedural details, pain scores, or adverse events were noted (P > .05). At 24 month of follow-up, patients in group A had a greater decrease in mean IPSS (18.7 ± 12.5 vs 14.8 ± 13.5), QOL score (3.7 ± 1.5 vs 2.4 ± 1.8), Qmax (10.5 mL ± 9.5 vs 6.8 mL ± 5.0), PVR (92.0 mL ± 75.0 vs 60.0 mL ± 55.0), and PV (37.0 mL ± 19.5 vs 25.5 mL ± 15.0) compared with patients in group B (P < .05 for all). Mean ratios of prostate ischemic volume at 1 week after PAE were 70% ± 20 in group A and 41% ± 25 in group B (P = .021); mean PSA levels at 24 hour after PAE were 92.5 ng/mL ± 55.0 in group A and 77.5 ng/mL ± 45.0 in group B (P = .031); LUTS recurrence rates were 3.6% in group A and 14.6% in group B (P = .024). The mean IIEF-5 was not significantly different from baseline in either group. CONCLUSIONS: PAE with 50-μm plus 100-μm PVA particles resulted in greater improvement in clinical and imaging outcomes and no significant differences in adverse events compared with 100-μm PVA particles alone. SN - 1535-7732 UR - https://www.unboundmedicine.com/medline/citation/30297313/Comparison_of_Clinical_Outcomes_of_Prostatic_Artery_Embolization_with_50_μm_Plus_100_μm_Polyvinyl_Alcohol__PVA__Particles_versus_100_μm_PVA_Particles_Alone:_A_Prospective_Randomized_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-0443(18)31293-4 DB - PRIME DP - Unbound Medicine ER -