Glue (n-Butyl Cyanoacrylate) for Prostate Artery Embolization: Development of a Glue Penetration Score and...

To develop a simple imaging-based scoring system, the prostate artery embolization (PAE)-glue penetration score (GPS; 0-6), for use in PAE with n-butyl cyanoacrylate (nBCA) and to examine how it relates to patient outcomes.

In a single-institution retrospective cohort of 49 men (July 2021 to May 2023), 2 blinded readers graded glue penetration per hemigland (0-3) and summed scores to a total PAE-GPS (0-6). The authors correlated GPS with International Prostate Symptom Score (IPSS), IPSS-quality of life (QoL), and Sexual Health Inventory for Men (SHIM) at 1, 6, and 12 months. The authors defined clinical success as achieving a ≥8-point or ≥25% reduction in IPSS plus a ≥1-point improvement in IPSS-QoL at any time point. The authors also analyzed outcomes by median lobe protrusion; adverse events were graded according to the Society of Interventional Radiology (SIR) adverse event criteria.

The median follow-up was 258 days (interquartile range, 138-391 days). GPS distributions were 5-6 (61.2%), 3-4 (28.5%), and 0-2 (10.2%). Clinical success rates were 92.5%, 75%, and 80%, respectively. Significant improvements in IPSS and IPSS-QoL scores were observed at all follow-up intervals (P < .001). SHIM scores increased significantly at 12 months (P = .044). A direct correlation was observed between higher PAE-GPS and improved clinical outcomes, with no significant adverse events reported.

nBCA PAE shows midterm safety and effectiveness. PAE-GPS provides a visible and reproducible technical endpoint. Higher PAE-GPS grades were associated with greater improvements on univariate analysis.