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Society of Interventional Radiology (SIR) 2026 Practice Guidance Document for Prostatic Artery Embolization.

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Prostatic Artery Embolization: Equipment, Procedure Steps, and Overcoming Technical Challenges.

Francisco Cesar Carnevale1, André Moreira de Assis1, Airton Mota Moreira1

  • 1Interventional Radiology Department, Radiology Institute, University of Sao Paulo Medical School, São Paulo, SP, Brazil.

Techniques in Vascular and Interventional Radiology
|December 14, 2020
PubMed
Summary

Prostatic artery embolization (PAE) effectively treats benign prostate hyperplasia (BPH) symptoms. This article details technical aspects and challenges for successful PAE procedures, aiding practitioners in mastering this complex interventional technique.

Keywords:
Benign prostatic hyperplasiaCone-beam computed tomographyLower urinary tract symptomsProstatic artery embolizationProximal Embolization FirstThen Embolize Distal (PErFecTED) technique

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Area of Science:

  • Interventional Radiology
  • Urology

Background:

  • Prostatic artery embolization (PAE) is a recognized treatment for lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH).
  • PAE is technically demanding due to complex prostatic vascular anatomy, patient comorbidities like atherosclerosis, and interconnected pelvic structures.

Purpose of the Study:

  • To describe and discuss the main technical concerns and challenges in performing PAE.
  • To provide strategies for overcoming common technical difficulties encountered during PAE.

Main Methods:

  • Review of essential equipment and embolic materials for PAE.
  • Discussion of patient preparation, arterial access, and prostatic artery identification/catheterization techniques.
  • Analysis of embolization strategies and common technical challenges.

Main Results:

  • PAE requires expertise in specialized materials, imaging, microcatheterization, and pelvic vascular anatomy.
  • Early PAE learning curves can involve prolonged procedure times and significant radiation exposure.
  • Key technical aspects include equipment selection, embolic agent choice, patient prep, access, and catheterization.

Conclusions:

  • Mastery of PAE demands comprehensive knowledge of its technical nuances.
  • Addressing challenges in PAE can optimize outcomes and patient safety.
  • This review offers insights into managing technical difficulties for improved PAE performance.