4:21 PM Abstract No. 71 Radial versus femoral artery access in prostate artery embolization: a multicenter experience in a major health system

Abstract

Prostate artery embolization (PAE) has been shown to be efficacious in treating men with urinary symptoms secondary to enlarged prostate glands. Initially performed with transfemoral access (TFA), targeted controlled studies have shown that PAE can be performed safely and effectively with transradial access (TRA). Our study examines different markers of PAE effectiveness, comparing TRA to TFA across a multicenter urban health system. Retrospective review of all PAE was performed from May 30, 2014, to June 29, 2019. Variables examined include access site, dose area product (DAP), fluoroscopy time (FT), pre and postprocedural International Prostate Symptom Score (IPSS), pre and postprocedural quality of life (QOL) scale, access site complications, and technical success (TS) (defined as bilateral prostate artery embolization to stasis). 147 PAE were performed over the 5-year period examined across 4 institutions, 111 with TRA and 36 with TFA. Median FT for TRA patients was 34.4 minutes, compared to 47.2 minutes for TFA (P <0.01). Median DAP was, 514797 and 733321 mGycm2 for TRA and TFA respectively (P = 0.01). IPSS (median, 20 for TRA; median, 20.75 for TFA) and QOL scores (median, 5 for TRA; median, 4 for TFA) were comparable in both groups prior to PAE (P = 0.25, P = 0.24), and the change of IPSS and QOL postprocedurally was not statistically significant between the two groups (P = 0.6, P = 0.07). There was one access site complication in the TFA group (small hematoma, not requiring intervention), with no access site complications in the TRA group. PAE can be safely performed via TRA or TFA with no difference in clinical outcome in a large multicenter urban health system. Decreased FT and DAP was seen in TRA cases.