Nontarget Radiopaque Embolic Deposition during Prostatic Artery Embolization

Area of Science:

• Interventional Radiology
• Urology
• Medical Imaging

Background:

• Prostatic artery embolization (PAE) is a minimally invasive treatment for lower urinary tract symptoms (LUTS).
• Nontarget embolization (NTE) is a potential complication of PAE, but its occurrence and impact with radiopaque particles are not well-defined.

Purpose of the Study:

• To evaluate the incidence of detectable nontarget embolization (NTE) during PAE using radiopaque embolic particles.
• To assess the safety and efficacy of PAE using these particles in patients with refractory LUTS.

Main Methods:

• Ten patients (>40 years) with large prostates (>50 mL) and refractory LUTS underwent PAE with 40-90 μm radiopaque spherical beads.
• Computed tomography (CT) scans were used to assess NTE at baseline and 3 months post-procedure.
• Clinical outcomes (IPSS, Qmax, QoL, IIEF, PVR) were tracked for 12 months.

Main Results:

• Radiographic NTE was observed in all patients.
• Significant improvements were noted in International Prostate Symptom Score (IPSS), quality of life (QoL), and peak urine flow rate (Qmax) at all time points (P < .05).
• No significant trends were observed in postvoid residual (PVR) or International Index of Erectile Function (IIEF). Minor adverse events occurred.

Conclusions:

• Detectable NTE is common during PAE with radiopaque particles but does not always correlate with postprocedural symptoms or clinical outcomes.
• PAE using radiopaque particles appears safe and effective for improving LUTS, QoL, and Qmax in men with large prostates.