TY - JOUR
T1 - Comparing embolic particles for prostatic artery embolization to treat lower urinary tract symptoms in patients with benign prostatic hyperplasia
AU - Bilhim, Tiago
AU - Vasco Costa, Nuno
AU - Torres, Daniel
AU - Akış, Serhat
AU - Alves, Marta
AU - Papoila, Ana Luisa
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to European Society of Radiology 2024.
PY - 2024
Y1 - 2024
N2 - Purpose: Compare the safety and efficacy of polyvinyl alcohol particles (PVA) versus trisacryl gelatin microspheres (Embospheres) versus hydrogel microspheres coated with polyzene-F (Embozenes) for prostatic artery embolization (PAE) to treat patients with benign prostatic hyperplasia (BPH). Materials and methods: A single-center prospective cohort study from 2019 to 2023, including patients with international prostate symptom score (IPSS) ≥ 15 and/or quality of life score (QoL) ≥ 4. Allocation to embolic agents was performed chronologically: 100–300 µm PVA (n = 53), followed by 300–500 µm Embospheres (n = 50), and finally, 400 µm Embozenes (n = 50). All patients were evaluated at baseline and at 1 and 6 months after PAE with IPSS/QoL; peak urinary flow rate, post-void residual volume, and prostate volume with ultrasound and prostate-specific antigen. Adverse events and the need for prostatic re-interventions were assessed. Results: There were no significant baseline differences between the three groups except for patient age (62.5 years PVA; 66.1 years Embospheres and 66.6 years Embozenes; p = 0.019). There were no major adverse events and no differences between groups regarding minor adverse events. All outcome measures improved significantly from baseline, with no significant differences between groups. Mean ± standard deviation IPSS/QoL improvement at 6 months: −10.7 ± 7.9/−2.2 ± 1.7 PVA; −10.4 ± 7.3/−2.0 ± 1.5 Embospheres; −10.4 ± 7.0/−2.2 ± 1.6 Embozenes (p = 0.987). Re-intervention rates after 6 months: 9% (n = 5/53) PVA; 14% (n = 7/50) Embospheres; 8% (n = 4/50) Embozenes (p = 0.591). Conclusions: PAE with PVA particles, Embospheres, and Embozenes is equally safe and effective in treating BPH-related lower urinary tract symptoms. Clinical relevance statement: This is the first prospective study showing equivalence between the most frequently used embolic agents for prostatic artery embolization. Key Points: Different particles can be used interchangeably for prostatic artery embolization. The improvements in measured metrics were the same between groups, with no differences in adverse events. The need for prostatic medication and re-intervention rates were the same at 1 and 6 months after embolization.
AB - Purpose: Compare the safety and efficacy of polyvinyl alcohol particles (PVA) versus trisacryl gelatin microspheres (Embospheres) versus hydrogel microspheres coated with polyzene-F (Embozenes) for prostatic artery embolization (PAE) to treat patients with benign prostatic hyperplasia (BPH). Materials and methods: A single-center prospective cohort study from 2019 to 2023, including patients with international prostate symptom score (IPSS) ≥ 15 and/or quality of life score (QoL) ≥ 4. Allocation to embolic agents was performed chronologically: 100–300 µm PVA (n = 53), followed by 300–500 µm Embospheres (n = 50), and finally, 400 µm Embozenes (n = 50). All patients were evaluated at baseline and at 1 and 6 months after PAE with IPSS/QoL; peak urinary flow rate, post-void residual volume, and prostate volume with ultrasound and prostate-specific antigen. Adverse events and the need for prostatic re-interventions were assessed. Results: There were no significant baseline differences between the three groups except for patient age (62.5 years PVA; 66.1 years Embospheres and 66.6 years Embozenes; p = 0.019). There were no major adverse events and no differences between groups regarding minor adverse events. All outcome measures improved significantly from baseline, with no significant differences between groups. Mean ± standard deviation IPSS/QoL improvement at 6 months: −10.7 ± 7.9/−2.2 ± 1.7 PVA; −10.4 ± 7.3/−2.0 ± 1.5 Embospheres; −10.4 ± 7.0/−2.2 ± 1.6 Embozenes (p = 0.987). Re-intervention rates after 6 months: 9% (n = 5/53) PVA; 14% (n = 7/50) Embospheres; 8% (n = 4/50) Embozenes (p = 0.591). Conclusions: PAE with PVA particles, Embospheres, and Embozenes is equally safe and effective in treating BPH-related lower urinary tract symptoms. Clinical relevance statement: This is the first prospective study showing equivalence between the most frequently used embolic agents for prostatic artery embolization. Key Points: Different particles can be used interchangeably for prostatic artery embolization. The improvements in measured metrics were the same between groups, with no differences in adverse events. The need for prostatic medication and re-intervention rates were the same at 1 and 6 months after embolization.
KW - Lower urinary tract symptoms (LUTS)
KW - Polyvinyl alcohol particles (PVA)
KW - Prostatic artery embolization (PAE), Benign prostatic hyperplasia (BPH)
KW - Trisacryl gelatin microspheres (Embospheres)
UR - http://www.scopus.com/inward/record.url?scp=85200911892&partnerID=8YFLogxK
U2 - 10.1007/s00330-024-10998-9
DO - 10.1007/s00330-024-10998-9
M3 - Article
C2 - 39107451
AN - SCOPUS:85200911892
SN - 0938-7994
JO - European Radiology
JF - European Radiology
ER -