Abstract No. 457 Safety and efficacy of 75-150 micron radiopaque beads for prostate artery embolization in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia

Abstract

To assess the efficacy and safety of using 75-150 micron radiopaque microspheres for prostate artery embolization (PAE) in treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). All patients with LUTS secondary to BPH who were treated with bilateral PAE using 75-150 micron radiopaque beads (M1 LUMI, BTG) were retrospectively reviewed. Patient demographics were obtained including patient age, prostate size, and Qmax. The primary outcomes were 3-month follow up improvement in International Prostate Symptoms Score (IPSS) and Quality of life (QOL) score. Adverse events including non-target embolization were assessed using CTCAE 4.03. Preparation of embolic solution involved diluting 2mL of bead product with 28mL of Isovue 370 and delivering 1ml aliquots until stasis via microcatheter in the target vessel. Non-contrast post embolization cone-beam CT (CBCT) was utilized in each case to identify non-target embolization (NTE). 10 men (mean age 76y, range 66 – 80y) underwent bilateral PAE via transradial (n=8) or transfemoral approach (n=2). 4 of these patients had indwelling urinary catheters and 1 was dependent on intermittent self-catheterization. Mean initial prostate volume was 115 cc (range 50 – 212 cc). Mean initial Qmax was 6.8 cc/s (range 3.4 – 10 cc/s). IPSS and QOL improved from 16 to 8.3 (p-value = 0.01) and from 4.8 to 3.3 (p-value = 0.14), respectively, at clinical follow up of average 49 days. NTE was observed in 1 patient manifesting as a small focus of bead deposition in the right rectum seen on CBCT. There was one Grade 1 AE (dysuria), one Grade 2 AE (UTI), and no major AE. Of the 4 patients that had indwelling urinary catheters, 2 of them were successfully removed at 28 and 30 days. PAE using 75-150 radiopaque beads is safe and effective in treating LUTS secondary to BPH with low rates of non-target deposition.