Abstract No. 61 Prostatic artery embolization with 100- to 300-μm microspheres to treat lower urinary tract symptoms attributable to benign prostatic hyperplasia: a single-center analysis of 4-year outcomes

Abstract

To present safety and efficacy data for up to 4 years of follow-up after 100-to 300-μm microsphere prostatic artery embolization (PAE) to treat lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). 135 consecutive patients who underwent PAE with 100- to 300-μm microspheres from April 2014 through February 2020 were retrospectively reviewed. Exclusion criteria included technical failure (unilateral or no embolization, n = 8), dementia (n = 3), new onset prostate cancer (n = 1), or loss to follow-up (n = 2). Subjects (n = 121, mean age = 72.3 ± 7.6, mean Charlson comorbidity index = 3.5 ± 1.6, mean prostate gland volume (PGV) = 128 ± 77mL) had mean pre-procedure International Prostate Symptoms Score (IPSS) = 21.7 ± 6.1, mean Quality of Life score (QoL) = 4.5 ± 1.2, and mean post-void residual (PVR) = 172 ± 165mL. After PAE, patients were evaluated at 1, 3, 6, 12, 24, 36, and 48 months. Comparisons to baseline values used Wilcoxon signed rank tests (IPSS, QoL) or T-tests (PGV, PVR). 30-day adverse events were recorded using Clavien-Dindo classification. Follow-up compliance was 68-85%. Substantial and statistically significant improvements were seen in IPSS and QoL through 48 months of follow-up. Post-treatment PVR and PGV were measured from 3 months onward, with substantial and statistically significant improvements seen through 24 months. Insufficient PVR and PGV data were available beyond 24 months. Within 30 days, 17 self-limited grade-1 adverse events occurred; 21 grade-2 adverse events occurred (retention < 1wk = 8, UTI = 9, DVT = 1, bladder ischemia = 1); there was 1 unrelated death. PAE with 100- to 300-μm microspheres produced sustained substantial improvements in LUTS, PVR, and PGV through 48 months. Outcomes were similar to transurethral surgeries with few serious adverse events, despite large pre-embolization gland volumes and substantial patient co-morbidities.