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Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
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Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Reply to Francesco Montorsi, Edoardo Pozzi, Marco Bianchi, et al's Letter to the Editor re: Gautier Müllhaupt, Lukas Hechelhammer, Nicole Graf, et al. Prostatic Artery Embolisation Versus Transurethral Resection of the Prostate for Benign Prostatic Obstruction: 5-year Outcomes of a Randomised, Open-label, Noninferiority Trial. Eur Urol Focus 2024;10:788-95.

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Prostatic Artery Embolisation: Do We Still Need It and for Whom?

Dominik Abt1, Pavel Lyatoshinsky1, Hans-Peter Schmid2

  • 1Department of Urology, Spitalzentrum Biel, Centre Hospitalier Bienne, Biel, Switzerland.

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|April 28, 2022
PubMed
Summary

Prostatic artery embolisation (PAE) is an effective, minimally invasive treatment for benign prostatic obstruction (BPO). This procedure offers a unique endovascular approach for selected patients with lower urinary tract symptoms (LUTS).

Keywords:
Benign prostatic hyperplasiaBenign prostatic obstructionLower urinary tracts symptomsMinimally invasive treatmentProstatic artery embolisation

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Area of Science:

  • Urology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Lower urinary tract symptoms (LUTS) are often caused by benign prostatic obstruction (BPO).
  • Prostatic artery embolisation (PAE) is an increasingly recognized treatment option for LUTS/BPO.
  • PAE offers a minimally invasive, endovascular alternative to traditional transurethral procedures.

Purpose of the Study:

  • To review the current evidence supporting the use of PAE for LUTS/BPO.
  • To examine the unique role and patient selection criteria for PAE.
  • To compare PAE with other established treatments for LUTS/BPO.

Main Methods:

  • Literature review of current evidence on PAE for LUTS/BPO.
  • Analysis of PAE's efficacy and safety data.
  • Comparison of PAE's endovascular approach with transurethral methods.

Main Results:

  • PAE is endorsed by international guidelines for selected patients with LUTS/BPO.
  • PAE demonstrates proven short- to mid-term efficacy and safety.
  • PAE's endovascular nature differentiates it from other LUTS/BPO treatments, influencing patient selection.

Conclusions:

  • PAE is a viable treatment option for carefully selected patients with LUTS/BPO.
  • The unique mechanism of PAE necessitates careful consideration in treatment planning.
  • Further research may elucidate long-term outcomes and optimal patient populations for PAE.