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Standardized Technique for Prostatic Artery Embolization: A Delphi Consensus Study on Optimized Methods and Emerging

Nassir Rostambeigi1, Marc Sapoval2, Tiago Bilhim3

  • 1Mallinckrodt Institute of Radiology, Washington University, Vascular and Intrventional Radiology, St. Louis, Missouri.

Journal of Vascular and Interventional Radiology : JVIR
|October 31, 2025
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Summary
This summary is machine-generated.

Prostatic artery embolization (PAE) offers a safe and effective treatment for benign prostatic hyperplasia symptoms. This consensus establishes evidence-based technical recommendations to standardize PAE procedures for optimal outcomes.

Area of Science:

  • Interventional Radiology
  • Urology
  • Medical Consensus Studies

Background:

  • Prostatic artery embolization (PAE) effectively manages lower urinary tract symptoms in men with benign prostatic hyperplasia.
  • PAE is technically demanding, requiring standardized procedures for optimal patient outcomes.
  • Patient-specific anatomy and operator factors present challenges to complete procedural standardization.

Purpose of the Study:

  • To establish a consensus on evidence-based technical recommendations for performing PAE.
  • To provide a structured framework for optimizing PAE outcomes.
  • To address key procedural domains in PAE.

Main Methods:

  • A Delphi methodology was employed, involving 14 international experts.
  • The study focused on six critical procedural domains of PAE.

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  • Recommendations were developed based on expert opinion and current literature.

    • Main Results:

    • The consensus provides a structured framework for PAE procedures.
    • Key areas covered include preprocedural imaging, antibiotic prophylaxis, arterial access, prostatic artery identification and cannulation, embolization techniques and materials, and non-target embolization prevention.
    • Emerging techniques like liquid embolic agents and coil-out methods are also discussed.

    Conclusions:

    • The panel identified the most effective technical methods for PAE, acknowledging procedural variations.
    • Further large-scale studies are recommended to validate or refine these consensus recommendations.