Prostate Artery Embolization: Safety, Technical Feasibility, and Clinical Outcomes in an Elderly Population

To evaluate the technical feasibility, safety, and clinical outcomes of prostate artery embolization (PAE) in patients aged ≥80 years.

This retrospective study included patients aged ≥80 years who underwent PAE between January 2015 and August 2025 for lower urinary tract symptoms (LUTS), catheter-dependent urinary retention, and/or hematuria. Technical and clinical success were defined as successful unilateral or bilateral embolization of the prostatic arterial supply and improvement in the primary indication within 12 months, respectively. Adverse events were classified according to the Society of Interventional Radiology grading system.

A total of 58 patients (mean age, 85.2±3.9 years) underwent PAE. Indications included LUTS in 29 (50.0%) patients, catheter-dependent urinary retention in 27 (46.6%), and hematuria in 15 (25.9%), with several patients presenting with more than one indication. Overall technical success was achieved in 57 (98.3%) patients. Clinical outcomes were evaluable in 52 (89.7%) patients after excluding those who died during follow-up, had incomplete follow-up, or had a technically unsuccessful procedure. At 12 months, mean International Prostate Symptom Score (IPSS) decreased from 18.7±6.1 to 9.3±4.9, and quality-of-life (QoL) score from 4.5±1.2 to 1.8±1.3 (both p<0.001). Catheter independence was achieved in 19/26 (73.1%) evaluable patients, and hematuria resolved in 12/12 (100%). Clinical success was achieved in 42/52 patients (80.8%). Postprocedural complications occurred in 10/52 (19.2%); none were severe or life-threatening.

PAE was technically feasible, safe, and effective in patients aged ≥80 years, supporting its use in non-surgical candidates or those who prefer a less invasive approach.