학술논문
Prostate artery embolization using n-butyl cyanoacrylate glue for symptomatic benign prostatic hyperplasia: A six-month outcome analysis in 103 patients.
Document Type
Academic Journal
Author
Loffroy R; Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France. Electronic address: romaric.loffroy@chu-dijon.fr.; Quirantes A; Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France.; Guillen K; Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France.; Mazit A; Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France.; Comby PO; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France; Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 21079 Dijon, France.; Aho-Glélé LS; Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand University Hospital, 21079 Dijon, France.; Chevallier O; Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France.
Source
Publisher: Elsevier Masson Country of Publication: France NLM ID: 101568499 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2211-5684 (Electronic) Linking ISSN: 22115684 NLM ISO Abbreviation: Diagn Interv Imaging Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: The purpose of this study was to assess the feasibility, safety, and 6-month outcomes of prostate artery embolization (PAE) using N-butyl-cyanoacrylate (NBCA) glue as the only embolic agent in patients with benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms.
Materials and Methods: Patients with BPH-related lower urinary tract symptoms who were treated by PAE using methacryloxysulfolane-NBCA mixed with ethiodized oil (1:8 ratio) between September 2018 and January 2023 were retrospectively included. Vascular mapping was made using cone-beam computed tomography angiography. PAEs were performed as an outpatient procedure, under local anaesthesia. Outcomes were assessed at six months using the International Prostate Symptoms Score (IPSS) and associated quality-of-life score (IPSS-QoL), prostate-specific antigen (PSA) level, prostate volume, and International Index of Erectile Function form 5 (IIEF5).
Results: A total of 103 men with a mean age of 68.4 ± 6 (standard deviation [SD]) years were included. Technical success rate was 100%. The mean fluoroscopy time was 26.4 ± 12.5 (SD) min and the median radiation dose was 23 980 mGy·cm (Q1, Q3: 16 770, 38 450). Compared to baseline, statistically significant improvements were observed at six months for the IPSS (8.9 ± 6.2 [SD] vs. 20.2 ± 6.5 [SD]; P = 0.01), IPSS-QoL (2.1 ± 1.4 [SD] vs. 5.1 ± 0.9 [SD]; P = 0.01), PSA level (3.6 ± 3.2 [SD] ng/mL vs. 4.8 ± 4.2 [SD] ng/mL; P = 0.0001), and prostate volume (78.6 ± 43.5 [SD] mL vs. 119.1 ± 65.7 [SD] mL; P = 0.01). Minor adverse events developed in 19/103 (18.4%) patients. No major complications occurred. Compared to baseline, the IIEF5 did not change significantly at six months (15.3 ± 6.8 [SD] vs. 15.8 ± 6.8 [SD]; P = 0.078).
Conclusion: PAE with NBCA is a feasible and safe method that provides good outcomes at six months in patients with BPH-related lower urinary tract symptoms. This method deserves further evaluation in randomized trials with longer follow-up.
Competing Interests: Declaration of competing interest RL serves as a consultant for Guerbet and GEM. The other authors declare no conflict of interest.
(Copyright © 2023 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)
Materials and Methods: Patients with BPH-related lower urinary tract symptoms who were treated by PAE using methacryloxysulfolane-NBCA mixed with ethiodized oil (1:8 ratio) between September 2018 and January 2023 were retrospectively included. Vascular mapping was made using cone-beam computed tomography angiography. PAEs were performed as an outpatient procedure, under local anaesthesia. Outcomes were assessed at six months using the International Prostate Symptoms Score (IPSS) and associated quality-of-life score (IPSS-QoL), prostate-specific antigen (PSA) level, prostate volume, and International Index of Erectile Function form 5 (IIEF5).
Results: A total of 103 men with a mean age of 68.4 ± 6 (standard deviation [SD]) years were included. Technical success rate was 100%. The mean fluoroscopy time was 26.4 ± 12.5 (SD) min and the median radiation dose was 23 980 mGy·cm (Q1, Q3: 16 770, 38 450). Compared to baseline, statistically significant improvements were observed at six months for the IPSS (8.9 ± 6.2 [SD] vs. 20.2 ± 6.5 [SD]; P = 0.01), IPSS-QoL (2.1 ± 1.4 [SD] vs. 5.1 ± 0.9 [SD]; P = 0.01), PSA level (3.6 ± 3.2 [SD] ng/mL vs. 4.8 ± 4.2 [SD] ng/mL; P = 0.0001), and prostate volume (78.6 ± 43.5 [SD] mL vs. 119.1 ± 65.7 [SD] mL; P = 0.01). Minor adverse events developed in 19/103 (18.4%) patients. No major complications occurred. Compared to baseline, the IIEF5 did not change significantly at six months (15.3 ± 6.8 [SD] vs. 15.8 ± 6.8 [SD]; P = 0.078).
Conclusion: PAE with NBCA is a feasible and safe method that provides good outcomes at six months in patients with BPH-related lower urinary tract symptoms. This method deserves further evaluation in randomized trials with longer follow-up.
Competing Interests: Declaration of competing interest RL serves as a consultant for Guerbet and GEM. The other authors declare no conflict of interest.
(Copyright © 2023 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)