Comparative Study Using 100–300 Versus 300–500 μm Microspheres for Symptomatic Patients Due to Enlarged-BPH Prostates

• Published in: Cardiovascular and interventional radiology Vol. 39; no. 10; pp. 1372 - 1378
• Main Authors: Gonçalves, Octavio Meneghelli, Carnevale, Francisco Cesar, Moreira, Airton Mota, Antunes, Alberto Azoubel, Rodrigues, Vanessa Cristina, Srougi, Miguel
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.10.2016
• Subjects: Acrylic Resins - therapeutic use; Aged; ANTIGENS; ARTERIES; BIOMEDICAL RADIOGRAPHY; BPH; Cardiology; Clinical Investigation; COMPARATIVE EVALUATIONS; Embolization, Therapeutic - methods; FLOW RATE; GELATIN; Gelatin - therapeutic use; Humans; Imaging; INDEXES; Lower Urinary Tract Symptoms - blood; Lower Urinary Tract Symptoms - complications; Lower Urinary Tract Symptoms - therapy; MAGNETIC RESONANCE; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; MICROSPHERES; Middle Aged; NMR IMAGING; Nuclear Medicine; Organ Size; PATIENTS; Prospective Studies; PROSTATE; Prostate - pathology; Prostate-Specific Antigen - blood; Prostatic Hyperplasia - blood; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - therapy; Quality of Life; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; SAFETY; SYMPTOMS; Treatment Outcome; Ultrasound; URINARY TRACT; URINE; VASCULAR DISEASES; Embolotherapy; Embolization; Prostate; Arterial intervention
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-016-1443-x

Purpose The purpose of the study was to compare safety and efficacy outcomes following prostate artery embolization (PAE) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 100–300 versus 300–500 μm tris-acryl gelatin microspheres. Materials and Methods Patients were prospectively treated between August 2011 and June 2013 to receive PAE with 100–300 μm (group A) or 300–500 μm (group B) tris-acryl gelatin microspheres. Patients were followed for a minimum of 12 months and were assessed for changes in International Prostate Symptom Score (IPSS), quality of life (QoL) index, prostate volume determined by magnetic resonance imaging, serum prostate specific antigen (PSA), and maximum urine flow rate (Q max ), as well as any treatment-related adverse events. Results Fifteen patients were included in each group, and PAE was technically successful in all cases. Both groups experienced significant improvement in mean IPSS, QoL, prostate volume, PSA, and Q max ( p  < 0.05 for all). The differences observed between the two groups included a marginally insignificant more adverse events ( p  = 0.066) and greater mean serum PSA reduction at 3 months of follow-up ( p  = 0.056) in group A. Conclusions Both 100–300 and 300–500 μm microspheres are safe and effective embolic agents for PAE to treat LUTS-related to BPH. Although functional and imaging outcomes did not differ significantly following use of the two embolic sizes, the greater incidence of adverse events with 100–300 μm microspheres suggests that 300–500 μm embolic materials may be more appropriate.