P07 Single centre experience of the balloon occlusion microcatheter for prostate artery embolisation (PAE)

Abstract

Abstract Introduction Prostate artery embolization (PAE) is an effective in patients with benign prostatic hyperplasia (BPH) particularly. Balloon occlusion PAE (bPAE) is novel procedural adaption to the standard technique using a 2.2fr microcatheter with a compliant silicone balloon. Methods Retrospective single centre study of the first experience of balloon occlusion microcatheter for PAE in the UK. All patients undergoing PAE in the last 18 months were identified and those who had bPAE were included. Results 22 patients were included in the study mean age 72 (11 IQR, 67.25-78.2). Median prostate volume was 121g (86.75 IQR, 57.5- 144.25). Median IPSS, Qmax and PVR at base line were 19 (5.25 IQR, 16-21.25), 7.4 ml/s (4.27 IQR, 5-9.35), 188 mls (255 IQR, 42.5 - 298) respectively. Four patients had long term catheters pre-procedure. Patients were embolised with 45-150 µm Contour PVA particles (n=8) or 250 µm Embozene microspheres (n = 14) (Boston Scientific, MA, USA). At 3 months post bPAE, MRI demonstrated prostate volume reduction of 31% (37.5± IQR, 11-48.5) with a further infarct of a median of 5ml (9.6 IQR, 0.95-10.6). IPSS reduction of 11 points (8.5 IQR, 7-15.5), Qmax of 11.6 ml/s (13.4 IQR, 4.8-18.2) and PVR of 98 mls (161 IQR, 19-180). Conclusion Balloon occlusion PAE is effective in reducing lower urinary tract symptoms. It effectively reversed the penile and rectal shunts in 8/22 cases with no cases of non-target embolization.