Tags

Type your tag names separated by a space and hit enter

Prostatic Artery Embolization Using 100-300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: A Single-Center Outcomes Analysis with Medium-Term Follow-up.
J Vasc Interv Radiol. 2020 Jan; 31(1):99-107.JV

Abstract

PURPOSE

To report medium-term outcomes of prostatic artery embolization (PAE) using 100-300-μm trisacryl gelatin microspheres to treat lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH) and to evaluate how cone-beam computed tomography-measured prostate gland volume (PGV), median lobe enlargement (MLE), age, and Charlson Comorbidity Index (CCI) affect these results.

MATERIALS AND METHODS

Seventy-four consecutive patients who underwent PAE from April 2014 through August 2018 were retrospectively reviewed. Patients had International Prostate Symptom Score (IPSS) >12, Quality of Life (QoL) score >2, prostate gland volume (PGV) >40 mL, age older than 45 years, and medical therapy failure. Twelve patients were excluded for bladder pathology or prostate cancer. Patients (n = 62, age = 71.8 ± 9.3 years, CCI = 3.5 ± 1.7, PGV = 174 ± 110 mL) had pre-procedure IPSS = 22.4 ± 5.6, QoL score = 4.4 ± 0.9, and post-void residual (PVR) = 172 ± 144 mL. Post-procedure values were compared to baseline at 1, 3, 6, 12, and 24 months. Associations between outcomes and PGV, MLE, age, and CCI were evaluated. Adverse event recording used Clavien-Dindo classification.

RESULTS

One month after PAE (n = 37), IPSS improved to 7.6 ± 5.2 (P < .0001) and QoL score improved to 1.7 ± 1.4 (P < .0001). At 3 months (n = 32), improvements continued, with IPSS = 6.4 ± 5.1 (P < .0001), QoL score = 1.2 ± 1.2 (P < .0001), PVR = 53 ± 41 mL (P < .001), and PGV = 73 ± 38 mL (P < .0001). Results were sustained at 6 months (n = 35): IPSS = 6.4 ± 4.1 (P < .0001), QoL score = 1.2 ± 1.2 (P < .0001), PVR = 68 ± 80 mL (P < .0001), PGV = 60 ± 19 mL (P < .001). At 12 months, patients (n = 26) had IPSS = 7.3 ± 5.5 (P < .0001), QoL score = 1.2 ± 0.8 (P <.0001), PVR = 89 ± 117 mL (P < .0001), PGV = 60 ± 48 mL (P < .01). At 24 months, patients (n = 8) had IPSS = 8.0 ± 5.4 (P < .0001), QoL score = 0.7 ± 0.5 (P < .0001), PVR = 91 ± 99mL (P = 0.17), and PGV = 30 ± 5mL (P = .11). Improvements were independent of PGV, MLE, age, and CCI. Two grade II urinary infections occurred.

CONCLUSIONS

PAE with 100-300-μm microspheres produced sustained substantial improvements in LUTS, PGV, and PVR, which were independent of baseline PGV, MLE, age, or CCI.

Authors+Show Affiliations

Yale University School of Medicine, 360 State Street, #3206, New Haven, CT 06511. Electronic address: raj.ayyagari@yale.edu.Yale University School of Medicine, 360 State Street, #3206, New Haven, CT 06511.Yale University School of Medicine, 360 State Street, #3206, New Haven, CT 06511.Yale University School of Medicine, 360 State Street, #3206, New Haven, CT 06511.Yale University School of Medicine, 360 State Street, #3206, New Haven, CT 06511.University of Miami School of Medicine, Miami, Florida.Yale University School of Medicine, 360 State Street, #3206, New Haven, CT 06511.Hartford Healthcare, Hartford, Connecticut.Yale University School of Medicine, 360 State Street, #3206, New Haven, CT 06511.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31771896

Citation

Ayyagari, Raj, et al. "Prostatic Artery Embolization Using 100-300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: a Single-Center Outcomes Analysis With Medium-Term Follow-up." Journal of Vascular and Interventional Radiology : JVIR, vol. 31, no. 1, 2020, pp. 99-107.
Ayyagari R, Powell T, Staib L, et al. Prostatic Artery Embolization Using 100-300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: A Single-Center Outcomes Analysis with Medium-Term Follow-up. J Vasc Interv Radiol. 2020;31(1):99-107.
Ayyagari, R., Powell, T., Staib, L., Chapiro, J., Raja, A., Bhatia, S., Chai, T., Schoenberger, S., & Devito, R. (2020). Prostatic Artery Embolization Using 100-300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: A Single-Center Outcomes Analysis with Medium-Term Follow-up. Journal of Vascular and Interventional Radiology : JVIR, 31(1), 99-107. https://doi.org/10.1016/j.jvir.2019.08.005
Ayyagari R, et al. Prostatic Artery Embolization Using 100-300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: a Single-Center Outcomes Analysis With Medium-Term Follow-up. J Vasc Interv Radiol. 2020;31(1):99-107. PubMed PMID: 31771896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prostatic Artery Embolization Using 100-300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: A Single-Center Outcomes Analysis with Medium-Term Follow-up. AU - Ayyagari,Raj, AU - Powell,Taylor, AU - Staib,Lawrence, AU - Chapiro,Julius, AU - Raja,Anusha, AU - Bhatia,Shivank, AU - Chai,Toby, AU - Schoenberger,Steven, AU - Devito,Ralph, Y1 - 2019/11/23/ PY - 2019/05/29/received PY - 2019/08/05/revised PY - 2019/08/05/accepted PY - 2019/11/28/pubmed PY - 2020/9/8/medline PY - 2019/11/28/entrez SP - 99 EP - 107 JF - Journal of vascular and interventional radiology : JVIR JO - J Vasc Interv Radiol VL - 31 IS - 1 N2 - PURPOSE: To report medium-term outcomes of prostatic artery embolization (PAE) using 100-300-μm trisacryl gelatin microspheres to treat lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH) and to evaluate how cone-beam computed tomography-measured prostate gland volume (PGV), median lobe enlargement (MLE), age, and Charlson Comorbidity Index (CCI) affect these results. MATERIALS AND METHODS: Seventy-four consecutive patients who underwent PAE from April 2014 through August 2018 were retrospectively reviewed. Patients had International Prostate Symptom Score (IPSS) >12, Quality of Life (QoL) score >2, prostate gland volume (PGV) >40 mL, age older than 45 years, and medical therapy failure. Twelve patients were excluded for bladder pathology or prostate cancer. Patients (n = 62, age = 71.8 ± 9.3 years, CCI = 3.5 ± 1.7, PGV = 174 ± 110 mL) had pre-procedure IPSS = 22.4 ± 5.6, QoL score = 4.4 ± 0.9, and post-void residual (PVR) = 172 ± 144 mL. Post-procedure values were compared to baseline at 1, 3, 6, 12, and 24 months. Associations between outcomes and PGV, MLE, age, and CCI were evaluated. Adverse event recording used Clavien-Dindo classification. RESULTS: One month after PAE (n = 37), IPSS improved to 7.6 ± 5.2 (P < .0001) and QoL score improved to 1.7 ± 1.4 (P < .0001). At 3 months (n = 32), improvements continued, with IPSS = 6.4 ± 5.1 (P < .0001), QoL score = 1.2 ± 1.2 (P < .0001), PVR = 53 ± 41 mL (P < .001), and PGV = 73 ± 38 mL (P < .0001). Results were sustained at 6 months (n = 35): IPSS = 6.4 ± 4.1 (P < .0001), QoL score = 1.2 ± 1.2 (P < .0001), PVR = 68 ± 80 mL (P < .0001), PGV = 60 ± 19 mL (P < .001). At 12 months, patients (n = 26) had IPSS = 7.3 ± 5.5 (P < .0001), QoL score = 1.2 ± 0.8 (P <.0001), PVR = 89 ± 117 mL (P < .0001), PGV = 60 ± 48 mL (P < .01). At 24 months, patients (n = 8) had IPSS = 8.0 ± 5.4 (P < .0001), QoL score = 0.7 ± 0.5 (P < .0001), PVR = 91 ± 99mL (P = 0.17), and PGV = 30 ± 5mL (P = .11). Improvements were independent of PGV, MLE, age, and CCI. Two grade II urinary infections occurred. CONCLUSIONS: PAE with 100-300-μm microspheres produced sustained substantial improvements in LUTS, PGV, and PVR, which were independent of baseline PGV, MLE, age, or CCI. SN - 1535-7732 UR - https://www.unboundmedicine.com/medline/citation/31771896/Prostatic_Artery_Embolization_Using_100_300_��m_Trisacryl_Gelatin_Microspheres_to_Treat_Lower_Urinary_Tract_Symptoms_Attributable_to_Benign_Prostatic_Hyperplasia:_A_Single_Center_Outcomes_Analysis_with_Medium_Term_Follow_up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-0443(19)30692-X DB - PRIME DP - Unbound Medicine ER -