03:18 PM Abstract No. 124 Utility of Emboguide with cone-beam CT in identification and navigation of prostatic arteries in prostate artery embolization compared with conventional 2D fluoroscopy with overlay technique: a prospective study

Abstract

To evaluate the role of embolization guidance software (Emboguide) with cone-beam CT in identifying prostatic arteries and assisting in endovascular navigation compared to conventional 2D angiogram with overlay technique for prostate artery embolization (PAE). IRB-approved prospective study (ClinicalTrials.gov Identifier: NCT03164629) was conducted, enrolling 50 patients undergoing PAE for benign prostatic hyperplasia or urinary retention, aged 50-79 with mean age of 65.7 years. 25 patients underwent PAE using Emboguide and 25 patients were treated with conventional 2D fluoroscopy with overlay. 300-500μm Embospheres were used in both groups. The primary outcome measurement was time to prostatic artery catheterization, which was defined as Emboguide display to catheter in prostate artery for the study group and display of 2D angiogram overlay to catheter in the prostatic artery for the control group. Prostatic arteries were identified in all 50 cases. Technical success (bilateral embolization) was achieved in 24/25 cases in both groups. Time to catheterization was 3 mins for the control group and 4.6 mins for the Emboguide group on the right (p<0.32) and 2.8 mins for the control group and 2.9 mins for the Emboguide group on the left (p<0.95). Fluoroscopy time was 44.5 mins for the control group and 33.0 mins for the Emboguide group (p<0.019). Total procedure time was 129.4 mins for control group and 84.6 mins for the Emboguide group (p<0.003). For additional parameter results, please refer to the table. Time to catheterization was not statistically significantly different between the 2 groups, however, Emboguide significantly reduced mean total procedure time and fluoroscopy time compared to conventional 2D fluoroscopic technique (p <0.05). These findings suggest Emboguide may be an additive tool for prostate artery identification, catheterization and can lead to reduced fluoroscopy and procedure times.Tabled 1Control Group vs Emboguide (with P Values)Parameter (mean)ControlEmboguideT-testProstate size (g)105.7109.80.814Time to catheterization (R) (min)3.04.60.32Time to catheterization (L) (min)2.82.90.95Fluoro time (min)44.5330.019Total procedure time (min)129.484.60.003Dose area product (mGy.cm2)30564255650.292Skin dose (mGy)251622720.628Contrast volume (mL)111.21290.064 Open table in a new tab