Abstract No. 485 Effects of tobacco abuse and other patient-specific comorbidities on technical success of prostate artery embolization

2021 ◽  
Vol 32 (5) ◽  
pp. S124
Author(s):  
A. Goloubev ◽  
C. DeClue ◽  
C. Davis
Keyword(s):  
Patient Specific ◽  
Technical Success ◽  
Artery Embolization ◽  
Prostate Artery Embolization ◽  
Tobacco Abuse

scholarly journals Angiographic Analysis of the Anatomical Variants in Genicular Artery Embolization

2021 ◽  
Author(s):  
Sandeep Bagla ◽  
Rachel Piechowiak ◽  
Abin Sajan ◽  
Julie Orlando ◽  
A Diego Hipolito Canario ◽  
...  
Keyword(s):  
Procedure Time ◽  
Technical Success ◽  
Artery Embolization ◽  
Novel Technique ◽  
Anterior Tibial ◽  
Branching Patterns ◽  
Genicular Artery ◽  
Arterial Anatomy ◽  
Lateral Superior Genicular Artery ◽  
Angiographic Findings

Abstract Purpose: Genicular artery embolization (GAE) has been proposed as a novel technique to treat painful synovitis related to osteoarthritis. An in-depth understanding of the genicular arterial anatomy is crucial to achieve technical success and avoid nontarget-related complications. Given the lack of previous angiographic description, the present study analyzes genicular arterial anatomy and proposes an angiographic classification system. Materials and Methods: Angiographic findings from 41 GAEs performed during two US clinical trials from January 2017 to July 2019 were reviewed to analyze the anatomical details of the following vessels: descending genicular artery (DGA), medial superior genicular artery (MSGA), medial inferior genicular artery (MIGA), lateral superior genicular artery (LSGA), lateral inferior genicular artery (LIGA), and anterior tibial recurrent artery (ATRA). The diameter, angle of origin, and anastomotic pathways were recorded for each vessel. The branching patterns were classified as: medially, M1 (3/3 arteries present) vs M2 (2/3 arteries present); and laterally, L1 (3/3 arteries present) vs L2 (2/3 arteries present). Results: A total of 91 genicular arteries were embolized: DGA (26.4%), MIGA (23.1%), MSGA (22.0%), LIGA (14.3%), and LSGA/ATRA (14.3%). The branching patterns were: medially = M1, 74.4% (n = 29), M2, 25.6% (n = 10); and laterally = L1, 94.9% (n = 37), L2, 5.1% (n = 2). A common origin for MSGA and LSGA was noted in 11 patients (28.2%). A direct DGA origin from the popliteal artery was reported in three patients (7.7%, n = 3). Conclusions: A thorough understanding of the geniculate arterial anatomy is important for maximizing postprocedural pain reduction while minimizing complications, procedure time, and radiation exposure during GAE.

scholarly journals Prostate artery embolization: a new, minimally invasive treatment for lower urinary tract symptoms secondary to prostate enlargement

2017 ◽  
Vol 9 (8) ◽  
pp. 209-216 ◽  
Author(s):  
Drew Maclean ◽  
Ben Maher ◽  
Sachin Modi ◽  
Mark Harris ◽  
Jonathan Dyer ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Benign Prostatic Obstruction ◽  
Artery Embolization ◽  
Invasive Treatment ◽  
Prostate Artery Embolization ◽  
Efficacious Treatment ◽  
Prostate Enlargement ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Prostate artery embolization (PAE) is emerging as a safe and efficacious treatment which approaches benign prostatic obstruction (BPO) from a unique perspective. This brings with it distinct advantages and solutions, which we discuss along with cost, evidence, complications and disadvantages.

scholarly journals A proof-of-concept study on the use of prostate artery embolization prior to definitive radiotherapy in prostate cancer

2020 ◽  
Author(s):  
Jeffrey Peacock ◽  
Dhiraj Sikaria ◽  
Laura Maun-Garcia ◽  
Khosrow Javedan ◽  
Kosj Yamoah ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Treatment ◽  
Organs At Risk ◽  
Statistical Significance ◽  
Volume Reduction ◽  
Proof Of Concept ◽  
Artery Embolization ◽  
Definitive Radiotherapy ◽  
Prostate Artery Embolization

Abstract Backgrounds: Prostatic artery embolization (PAE) has been well studied as a clinically effective therapy for alleviating lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). We demonstrate a proof of concept for PAE prior to definitive radiotherapy in patients with prostate cancer.Methods: From 12/2017 to 07/2019, 57 patients underwent PAE for LUTS and BPH. Nine of these patients had PAE for LUTS in the setting of localized prostate cancer prior to receiving radiation. Five of the nine patients received their entire radiotherapy course at our institution and had clinical follow up were included in the analysis. Median follow up was 18 months from the time of PAE. LUTS improvement quantified by IPSS was the primary endpoint and a two tail students T test was used to compare statistical significance. Side effects during radiation were quantified using the CTCAE scoring system. Pre- and post- PAE plans were compared in the five patients that by performing an isovolumetric expansion of the post PAE plan (treated plan) equivalent to the measured volume reduction after PAE. Patient 1 and 2 had prostate and seminal vesicle RT alone while patients 3-5 had prostate with elective nodal coverage. Mean doses to organs at risk were compared between the two plans.Results: The average IPSS score pre-PAE was 17.40 compared to post-PAE of 3.6 (p=0.02). The average IPSS score reduction after PAE was 13.8 (5-30). The average prostatic volume reduction after PAE was 23.14% (7.2% - 47.7%). There were no CTCAE grade 3 (severe) or higher during radiation treatment. Post-PAE plans in patient 1 and 2 had on average 16.7% and 39.8% decrease in mean dose across the bladder, rectum, and penile bulb compared to the pre-PAE plans. There were no appreciable differences in dosimetry in the patients 3-5 who had nodal coverage. There was no biochemical failure in any of the patients.Conclusion: We demonstrate a proof of concept that prostate artery embolization is useful as an adjunctive procedure to alleviate LUTS, achieve significant volume reduction prior to radiation therapy, and decrease radiation related toxicity in the treatment of prostate cancer.

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