Efficacy of Prostatic Artery Embolization for Catheter-Dependent Patients with Large Prostate Sizes and High Comorbidity Scores

Shivank Bhatia, Vishal K. Sinha, Bruce Kava, Christopher Gomez, Sardis Harward, Sanoj Punnen, Mohamed Kably, Jeffrey Miller, Dipen J Parekh

Research output: Contribution to journalArticle

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Abstract

Purpose To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter–dependent patients with large prostate volumes and high comorbidity scores. Materials and Methods A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48–94 y), age-adjusted Charlson comorbidity index was 4.5 (0–10), duration of urinary retention was 63.4 days (2–224 d), International Prostate Symptom Score quality-of-life (IPSS-QOL) was 5.3 (3–6), and prostate volume was 167.3 cm3 (55–557 cm3). These parameters were collected at 3, 6, and 12 months after PAE. Trials of voiding were performed approximately 2 weeks after PAE and, if failed, every 2 weeks thereafter. Adverse events were graded using the Clavien-Dindo classification. Results At a mean (range) of 18.2 days (1–72 d), 26 (86.7%) patients were no longer reliant on catheters. Follow-up was obtained in all patients eligible at 3 and 6 months and 17 of 20 (85.0%) patients eligible at 1 year. Mean (range) IPSS-QOL improved significantly to 1.2 (0–5), 0.7 (0–4), and 0.6 (0–4) at 3, 6, and 12 months (all P <.001). Mean (range) prostate volume decreased significantly to 115.9 cm3 (27–248 cm3) at 3 months (P <.001). Two patients experienced grade II urosepsis complications, which were successfully treated with intravenous antibiotics. All other complications were self-limited grade I complications. Conclusions PAE represents a safe and effective option for management of patients with urinary retention, especially patients with large prostates who are not ideal surgical candidates.

Original languageEnglish (US)
Pages (from-to)78-84.e1
JournalJournal of Vascular and Interventional Radiology
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2018

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Comorbidity
Prostate
Catheters
Arteries
Urinary Retention
Quality of Life
Anti-Bacterial Agents
Safety

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Efficacy of Prostatic Artery Embolization for Catheter-Dependent Patients with Large Prostate Sizes and High Comorbidity Scores. / Bhatia, Shivank; Sinha, Vishal K.; Kava, Bruce; Gomez, Christopher; Harward, Sardis; Punnen, Sanoj; Kably, Mohamed; Miller, Jeffrey; Parekh, Dipen J.

In: Journal of Vascular and Interventional Radiology, Vol. 29, No. 1, 01.01.2018, p. 78-84.e1.

Research output: Contribution to journalArticle

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abstract = "Purpose To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter–dependent patients with large prostate volumes and high comorbidity scores. Materials and Methods A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48–94 y), age-adjusted Charlson comorbidity index was 4.5 (0–10), duration of urinary retention was 63.4 days (2–224 d), International Prostate Symptom Score quality-of-life (IPSS-QOL) was 5.3 (3–6), and prostate volume was 167.3 cm3 (55–557 cm3). These parameters were collected at 3, 6, and 12 months after PAE. Trials of voiding were performed approximately 2 weeks after PAE and, if failed, every 2 weeks thereafter. Adverse events were graded using the Clavien-Dindo classification. Results At a mean (range) of 18.2 days (1–72 d), 26 (86.7{\%}) patients were no longer reliant on catheters. Follow-up was obtained in all patients eligible at 3 and 6 months and 17 of 20 (85.0{\%}) patients eligible at 1 year. Mean (range) IPSS-QOL improved significantly to 1.2 (0–5), 0.7 (0–4), and 0.6 (0–4) at 3, 6, and 12 months (all P <.001). Mean (range) prostate volume decreased significantly to 115.9 cm3 (27–248 cm3) at 3 months (P <.001). Two patients experienced grade II urosepsis complications, which were successfully treated with intravenous antibiotics. All other complications were self-limited grade I complications. Conclusions PAE represents a safe and effective option for management of patients with urinary retention, especially patients with large prostates who are not ideal surgical candidates.",
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AU - Gomez, Christopher

AU - Harward, Sardis

AU - Punnen, Sanoj

AU - Kably, Mohamed

AU - Miller, Jeffrey

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N2 - Purpose To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter–dependent patients with large prostate volumes and high comorbidity scores. Materials and Methods A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48–94 y), age-adjusted Charlson comorbidity index was 4.5 (0–10), duration of urinary retention was 63.4 days (2–224 d), International Prostate Symptom Score quality-of-life (IPSS-QOL) was 5.3 (3–6), and prostate volume was 167.3 cm3 (55–557 cm3). These parameters were collected at 3, 6, and 12 months after PAE. Trials of voiding were performed approximately 2 weeks after PAE and, if failed, every 2 weeks thereafter. Adverse events were graded using the Clavien-Dindo classification. Results At a mean (range) of 18.2 days (1–72 d), 26 (86.7%) patients were no longer reliant on catheters. Follow-up was obtained in all patients eligible at 3 and 6 months and 17 of 20 (85.0%) patients eligible at 1 year. Mean (range) IPSS-QOL improved significantly to 1.2 (0–5), 0.7 (0–4), and 0.6 (0–4) at 3, 6, and 12 months (all P <.001). Mean (range) prostate volume decreased significantly to 115.9 cm3 (27–248 cm3) at 3 months (P <.001). Two patients experienced grade II urosepsis complications, which were successfully treated with intravenous antibiotics. All other complications were self-limited grade I complications. Conclusions PAE represents a safe and effective option for management of patients with urinary retention, especially patients with large prostates who are not ideal surgical candidates.

AB - Purpose To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter–dependent patients with large prostate volumes and high comorbidity scores. Materials and Methods A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48–94 y), age-adjusted Charlson comorbidity index was 4.5 (0–10), duration of urinary retention was 63.4 days (2–224 d), International Prostate Symptom Score quality-of-life (IPSS-QOL) was 5.3 (3–6), and prostate volume was 167.3 cm3 (55–557 cm3). These parameters were collected at 3, 6, and 12 months after PAE. Trials of voiding were performed approximately 2 weeks after PAE and, if failed, every 2 weeks thereafter. Adverse events were graded using the Clavien-Dindo classification. Results At a mean (range) of 18.2 days (1–72 d), 26 (86.7%) patients were no longer reliant on catheters. Follow-up was obtained in all patients eligible at 3 and 6 months and 17 of 20 (85.0%) patients eligible at 1 year. Mean (range) IPSS-QOL improved significantly to 1.2 (0–5), 0.7 (0–4), and 0.6 (0–4) at 3, 6, and 12 months (all P <.001). Mean (range) prostate volume decreased significantly to 115.9 cm3 (27–248 cm3) at 3 months (P <.001). Two patients experienced grade II urosepsis complications, which were successfully treated with intravenous antibiotics. All other complications were self-limited grade I complications. Conclusions PAE represents a safe and effective option for management of patients with urinary retention, especially patients with large prostates who are not ideal surgical candidates.

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