RADIATION DOSES TO ANAESTHETISTS DURING PROSTATIC ARTERY EMBOLIZATION INTERVENTIONAL PROCEDURES

2019 ◽  
Vol 185 (2) ◽  
pp. 196-200
Author(s):  
W J Garzón ◽  
H J Khoury
Keyword(s):  
Radiation Doses ◽  
Dose Equivalent ◽  
Dose Limit ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Protection Measures ◽  
Oblique Projections ◽  
Reference Hospital ◽  
The City ◽  
Prostatic Artery

Abstract The objective of this study was to assess the radiation doses received by anaesthetists from prostatic artery embolization (PAE) procedures. Ten PAE procedures conducted in a reference hospital in the city of Recife, Brazil were investigated. Occupational dosimetry was performed using thermoluminescent dosemeters which were located next to the eyes, close to the thyroid (over the shielding), on the thorax (under the apron), on the wrist and on the feet of the physician’s body. The results showed that the anaesthetist’s feet received the highest doses followed by the eyes and the hands. In some complex PAE procedures the doses received by anaesthetists on the lens of the eyes and the effective dose were higher than those received by the main operator due to the anaesthetist’s close position to the patient’s table and the use of oblique projections. The personal dose equivalent Hp(3) per procedure for the anaesthetist’s right eyebrow ranged from 20.2 μSv to 568.3 μSv. This result shows that anaesthetists assisting PAE procedures can exceeds the annual eye lens dose limit of 20 mSv recommended by the ICRP with only one procedure per week if radiation protection measures are not implemented during procedures.

scholarly journals Prostatic artery embolization performed in anteroposterior projections versus steep oblique projections: single centre retrospective comparative analysis

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hippocrates Moschouris ◽  
Andreas Dimakis ◽  
Marina G. Papadaki ◽  
Athanasios Liarakos ◽  
Konstantinos Stamatiou ◽  
...  
Keyword(s):  
Clinical Success ◽  
Computed Tomographic Angiography ◽  
Success Rates ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Dose Area Product ◽  
Computed Tomographic ◽  
Oblique Projections ◽  
Internal Iliac ◽  
Prostatic Artery

Abstract Background To present and evaluate an approach for reduction of utilization of steep oblique angiographic projections during prostatic artery embolization (PAE). Methods Single-center, retrospective study of patients who underwent bilateral PAE (from October 2018 to November 2019) and in whom it was possible to embolize PA of at least one pelvic side utilizing anteroposterior projections only (AP-PAE group), with the following techniques: Identification of the origin of PA on anteroposterior angiographic views. Utilization of anatomic landmarks from the planning computed tomographic angiography. Distal advancement of the angiographic catheter or microcatheter in the anterior division of internal iliac artery. Gentle probing with microguidewire at the expected site of origin of the PA. The AP-PAE approach was initially applied to all PAE patients during the study period and when this approach failed, additional steep oblique projections were acquired; patients who underwent bilateral PAE, with both anteroposterior and oblique projections for both pelvic sides, formed the standard PAE (S-PAE) group. The AP-PAE group was compared with S-PAE group in terms of baseline clinical and anatomic features, technical/procedural aspects and outcomes. Results Forty-six patients (92 pelvic sides) were studied. AP-PAE was feasible in 12/46 patients (26.0%): unilateral AP-PAE in 9/46 patients (19.5%); bilateral AP-PAE in 3/46 patients (6.5%). AP-PAE group had larger prostates (p = 0.047) and larger PAs (p < 0.001). Body mass index (BMI) and other baseline features were comparable between the two groups (mean BMI, AP-PAE group: 27.9 ± 3.6, S-PAE group: 27.0 ± 3.5, p = 0.451). Mean fluoroscopy time and dose area product were lower in AP-PAE group (46.3 vs 57.9 min, p = 0.084 and 22,924.9 vs 35,800.4 μGy.m2, p = 0.018, respectively). Three months post PAE, comparable clinical success rates (11/12 vs 31/34, p = 0.959) and mean International Prostate Symptom Score reduction (60.2% vs 58.1%, p = 0.740) were observed for AP-PAE and for S-PAE group, respectively. No major complications were encountered. Conclusion AP-PAE is associated with significant reduction in radiation exposure and appears to be feasible, safe and effective, but it can be applied in a relatively small percentage of patients.

scholarly journals Prostatic Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP) have a Differential Impact on Lower Urinary Tract Symptoms (LUTS): Retrospective Analysis of the Multicentre UK-ROPE (UK Register of Prostate Embolization) Study

2021 ◽  
Author(s):  
Ganesh Vigneswaran ◽  
Drew Maclean ◽  
Mohammed Hadi ◽  
Benjamin Maher ◽  
Sachin Modi ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Transurethral Resection ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Voiding Symptoms ◽  
Significant Difference ◽  
Student’S T ◽  
The Uk ◽  
And Storage ◽  
Prostatic Artery

Abstract Purpose To compare the relative IPSS (International Prostate Symptom Score) improvement in storage and voiding symptoms between prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP). Method Retrospective analysis of the UK-ROPE (UK Register of Prostate Embolization) multicentre database was conducted with inclusion of all patients with full IPSS questionnaire score data. The voiding and storage subscore improvement was compared between interventions. Student’s t-test (paired and unpaired) and ANOVA (Analysis of variance) were used to identify significant differences between the groups. Results 146 patients (121 PAE, 25 TURP) were included in the analysis. Storage symptoms were more frequently the most severe symptom (‘storage’ in 75 patients vs ‘voiding’ in 17 patients). Between groups, no significant difference was seen in raw storage subscore improvement (TURP 4.9 vs PAE 4.2; p = 0.34) or voiding subscore improvement (TURP 8.4 vs PAE 6.7; p = 0.1). ANOVA demonstrated a greater proportionate reduction (relative to total IPSS) towards voiding symptoms in the TURP group (27.3% TURP vs 9.9% PAE, p = 0.001). Conclusion Although both TURP and PAE improve voiding symptoms more than storage, a significantly larger proportion of total symptom reduction is due to voiding in the TURP cohort, with PAE providing a more balanced improvement between voiding and storage.

scholarly journals Abstract No. 238 Causes of technical failure in bilateral prostatic artery embolization

2021 ◽  
Vol 32 (5) ◽  
pp. S104
Author(s):  
S. Maron ◽  
H. Sharma ◽  
N. Galla ◽  
M. Cedillo ◽  
A. Sher ◽  
...  
Keyword(s):  
Technical Failure ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Prostatic Artery

scholarly journals Prostatic Artery Embolization: An Alternative Treatment for Benign Prostatic Hyperplasia

2021 ◽  
Vol 5 (02) ◽  
pp. 091-098
Author(s):  
James F. Pike ◽  
William F. Abel ◽  
Tyler B. Seckel ◽  
Christine M.G. Schammel ◽  
William Flanagan ◽  
...  
Keyword(s):  
Prostate Volume ◽  
Medical Center ◽  
Specific Antigen ◽  
Outcome Data ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Optimal Care ◽  
International Prostatic Symptom Score ◽  
Simple Prostatectomy ◽  
Prostatic Artery

Abstract Purpose Prostatic artery embolization (PAE) has emerged as a minimally invasive alternative for patients with prostates >80 mL and has demonstrated lower morbidity rates. We sought to evaluate PAE at a single tertiary medical center. Methods A retrospective review of all patients who underwent PAE was completed. Demographic, clinicopathologic, procedure, and outcome data were collected to include international prostatic symptom score (IPSS) and quality of life (QoL) assessments. Results The pre-PAE mean prostate-specific antigen (PSA) was 8.4 ng/mL, mean prostate volume was 146.9 mL (9% >200 mL), and mean postvoid residual (PVR) was 208.2 mL (21.9% 200–300 mL). IPSS mean was 19.8 and QoL was “mostly dissatisfied.” Following PAE, mean PSA was reduced by 3.2 ng/mL (38.1%, p = 0.3014), the mean prostate volume reduction was 59.2 mL (40.3%, n = 19, p < 0.0001), and the average PVR reduction was 150.3 mL (72.2%, n = 27, p = 0.0002). Average IPSS score was also lower (11.9; 60.1%, n = 25, p < 0.0001) and QoL was reduced to “mostly satisfied” (p < 0.0001). Technical success was 100% with 24% minor morbidities. Conclusion PAE is a successful treatment for patients with BPH resulting in large prostates that are not good candidates for simple prostatectomy, providing optimal care with less operative and postoperative complications.

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