Safety Profile of Ambulatory Prostatic Artery Embolization after a Significant Learning Curve: Update on Adverse Events.

embolization endovascular procedure interventional prostate prostatic hyperplasia radiology therapeutic

Journal

Journal of personalized medicine
ISSN: 2075-4426
Titre abrégé: J Pers Med
Pays: Switzerland
ID NLM: 101602269

Informations de publication

Date de publication:
31 Jul 2022
Historique:
received: 19 06 2022
revised: 18 07 2022
accepted: 26 07 2022
entrez: 26 8 2022
pubmed: 27 8 2022
medline: 27 8 2022
Statut: epublish

Résumé

to report the safety of outpatient prostatic artery embolization (PAE) after a significant learning curve. a retrospective bi-institutional study was conducted between June 2018 and April 2022 on 311 consecutive patients, with a mean age of 69 years ± 9.8 (47-102), treated by outpatient PAE. Indications included lower urinary tract symptoms, acute urinary retention, and hematuria. When needed, 3D-imaging and/or coil protection of extra-prostatic supplies were performed to avoid non-target embolization. Adverse events were monitored at 1-, 6-, and 12-month follow-ups. bilateral PAE was achieved in 305/311 (98.1%). Mean dose area product/fluoroscopy times were 16,408.3 ± 12,078.9 (2959-81,608) μGy.m outpatient PAE performed after achieving a significant learning curve may lead to a decreased and low rate of adverse events. Experience in arterial anatomy and coil protection may play a role in safety, but the necessity of the latter in some patterns may need confirmation by additional studies in randomized designs.

Sections du résumé

BACKGROUND BACKGROUND
to report the safety of outpatient prostatic artery embolization (PAE) after a significant learning curve.
METHODS METHODS
a retrospective bi-institutional study was conducted between June 2018 and April 2022 on 311 consecutive patients, with a mean age of 69 years ± 9.8 (47-102), treated by outpatient PAE. Indications included lower urinary tract symptoms, acute urinary retention, and hematuria. When needed, 3D-imaging and/or coil protection of extra-prostatic supplies were performed to avoid non-target embolization. Adverse events were monitored at 1-, 6-, and 12-month follow-ups.
RESULTS RESULTS
bilateral PAE was achieved in 305/311 (98.1%). Mean dose area product/fluoroscopy times were 16,408.3 ± 12,078.9 (2959-81,608) μGy.m
CONCLUSION CONCLUSIONS
outpatient PAE performed after achieving a significant learning curve may lead to a decreased and low rate of adverse events. Experience in arterial anatomy and coil protection may play a role in safety, but the necessity of the latter in some patterns may need confirmation by additional studies in randomized designs.

Identifiants

pubmed: 36013210
pii: jpm12081261
doi: 10.3390/jpm12081261
pmc: PMC9409998
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

J Vasc Interv Radiol. 2020 Jun;31(6):882-890
pubmed: 32249193
Cardiovasc Intervent Radiol. 2018 Jan;41(1):191-196
pubmed: 28828518
Eur Radiol. 2019 Jan;29(1):287-298
pubmed: 29948079
J Vasc Interv Radiol. 2018 Jan;29(1):85-89
pubmed: 29258665
Cardiovasc Intervent Radiol. 2018 Nov;41(11):1664-1673
pubmed: 30128781
Cardiovasc Intervent Radiol. 2016 Mar;39(3):367-75
pubmed: 26702619
Cardiovasc Intervent Radiol. 2017 Jan;40(1):22-32
pubmed: 27872988
J Endovasc Ther. 2019 Apr;26(2):181-190
pubmed: 30741067
J Vasc Interv Radiol. 2019 Nov;30(11):1798-1806
pubmed: 31587950
J Vasc Interv Radiol. 2016 Aug;27(8):1115-22
pubmed: 27321890
J Vasc Interv Radiol. 2019 May;30(5):638-644
pubmed: 31029381
J Vasc Interv Radiol. 2016 Aug;27(8):1266-8
pubmed: 27449986
J Vasc Interv Radiol. 2015 Oct;26(10):1580-2
pubmed: 26408222
J Vasc Interv Radiol. 2017 Jun;28(6):898-905
pubmed: 28396191
J Vasc Interv Radiol. 2017 Oct;28(10):1432-1437.e3
pubmed: 28757285
Radiology. 2014 Mar;270(3):920-8
pubmed: 24475799
J Vasc Interv Radiol. 2016 Nov;27(11):1686-1697.e8
pubmed: 27742235
J Vasc Interv Radiol. 2015 Jan;26(1):87-93
pubmed: 25541446
J Vasc Interv Radiol. 2019 Feb;30(2):217-224
pubmed: 30661948
BMC Urol. 2018 Oct 24;18(1):92
pubmed: 30355294
Cardiovasc Intervent Radiol. 2018 Aug;41(8):1295-1297
pubmed: 29520430
J Vasc Interv Radiol. 2016 Apr;27(4):601-3
pubmed: 27013006
Cardiovasc Intervent Radiol. 2016 Sep;39(9):1245-55
pubmed: 27412754
J Vasc Interv Radiol. 2016 Oct;27(10):1487-1493.e1
pubmed: 27345338
Eur Urol. 2021 Jul;80(1):34-42
pubmed: 33612376
J Vasc Interv Radiol. 2017 May;28(5):656-664.e3
pubmed: 28284886
AJR Am J Roentgenol. 2016 Feb;206(2):442-4
pubmed: 26797376
BMJ. 2018 Jun 19;361:k2338
pubmed: 29921613
J Vasc Interv Radiol. 2018 Dec;29(12):1694-1702
pubmed: 30297313
J Vasc Interv Radiol. 2017 Sep;28(9):1276-1278
pubmed: 28841930
Cardiovasc Intervent Radiol. 2016 Jan;39(1):44-52
pubmed: 26506952
Cardiovasc Intervent Radiol. 2011 Dec;34(6):1330-3
pubmed: 21387120
Cardiovasc Intervent Radiol. 2015 Jun;38(3):755-9
pubmed: 25799951
Cardiovasc Intervent Radiol. 2017 Jun;40(6):937-941
pubmed: 28175975
J Vasc Interv Radiol. 2016 Feb;27(2):295-7
pubmed: 26830948
J Vasc Interv Radiol. 2016 Nov;27(11):1745-1747
pubmed: 27926408
Cardiovasc Intervent Radiol. 2015 Aug;38(4):855-61
pubmed: 25962991
J Vasc Interv Radiol. 2018 Nov;29(11):1595-1600.e9
pubmed: 30293730
Cardiovasc Intervent Radiol. 2013 Dec;36(6):1690-1694
pubmed: 24091752
J Vasc Interv Radiol. 2019 Sep;30(9):1459-1470
pubmed: 31375451

Auteurs

Gregory Amouyal (G)

Ramsay Santé-Hôpital Privé Geoffroy Saint-Hilaire, 75005 Paris, France.
Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.

Louis Tournier (L)

Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.
Faculté de Médecine, Université Paris Cité, 75006 Paris, France.

Constance De Margerie-Mellon (C)

Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.
Faculté de Médecine, Université Paris Cité, 75006 Paris, France.

Atanas Pachev (A)

Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.
Faculté de Médecine, Université Paris Cité, 75006 Paris, France.

Jessica Assouline (J)

Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.
Faculté de Médecine, Université Paris Cité, 75006 Paris, France.

Damien Bouda (D)

Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.
Faculté de Médecine, Université Paris Cité, 75006 Paris, France.

Cédric De Bazelaire (C)

Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.
Faculté de Médecine, Université Paris Cité, 75006 Paris, France.

Florent Marques (F)

Ramsay Santé-Hôpital Privé Geoffroy Saint-Hilaire, 75005 Paris, France.

Solenne Le Strat (S)

Ramsay Santé-Hôpital Privé Geoffroy Saint-Hilaire, 75005 Paris, France.

François Desgrandchamps (F)

Faculté de Médecine, Université Paris Cité, 75006 Paris, France.
Urology Department, Hôpital Saint-Louis, 75010 Paris, France.
SRHI/CEA-Institut de Recherche Clinique Saint-Louis, Hôpital Saint-Louis, 75010 Paris, France.

Eric De Kerviler (E)

Radiology Department, Hôpital Saint-Louis, 75010 Paris, France.
Faculté de Médecine, Université Paris Cité, 75006 Paris, France.

Classifications MeSH