Artery Embolization In Patients Research Articles

Emergency Department Visits for Chronic Subdural Hematomas within 30 Days after Surgical Evacuation with and without Middle Meningeal Artery Embolization.

Middle meningeal artery embolization after surgical evacuation of a chronic subdural hematomas is associated with fewer treatment failures than surgical evacuation. We compared emergency department visits within 30 days for patients with chronic subdural hematomas with and without adjunctive middle meningeal artery embolization. All cases of chronic subdural hematoma treated from January 1, 2018, through December 31, 2020, were retrospectively reviewed. Treatment was classified as surgery only or surgery combined with middle meningeal artery embolization. The primary outcome was 30-day emergency department presentation and readmission. Of 137 patients who met the study criteria, 28 (20%) underwent surgery combined with middle meningeal artery embolization. Of these 28 patients, 15 (54%) underwent planned middle meningeal artery embolization and 13 (46%) underwent embolization after surgical failure. The mean chronic subdural hematoma size at presentation in the group with surgery only (n = 109, 20.5 [SD, 6.9] mm) was comparable with that in the combined group (n = 28, 18.7 [SD, 4.5] mm; P = .16). A significantly higher percentage of the surgery-only group presented to the emergency department within 30 days compared with the combined group (32 of 109 [29%] versus 2 of 28 [7%] patients; P = .02). No significant difference was found with respect to readmission (16 [15%] versus 1 [4%] patient; P = .11). Nine patients (8%) in the surgery-only group were readmitted for significant reaccumulation or residual subdural hematoma compared with only 1 patient (4%) in the combined group (P = .40). Surgical evacuation combined with middle meningeal artery embolization in patients with chronic subdural hematoma is associated with fewer 30-day emergency department visits compared with surgery alone.

Prostate Artery Embolization in Patients above Eighty Years Old: Clinical Efficacy and Safety

Abstract Objectives Prostate artery embolization (PAE) has been established as an effective treatment option for benign prostate hyperplasia or hematuria of prostatic origin. We aim to confirm the effectiveness and safety of PAE in elderly patients aged ≥ 80 years old. Materials and Methods Between January 2014 and August 2020, PAE was attempted on 54 elderly patients with lower urinary tract symptoms (LUTS) or prostatic hematuria who were unfit for surgical treatment or opted for PAE. Outcome parameters (International Prostate Symptom Score [IPSS], quality of life [QoL] score, International Index of Erectile Function score (IIEF), maximal urinary flow rate, postvoid residual, and prostate volume) were collected and analyzed at baseline, 6 months, 1, 2, and 3 years. Results The mean patient age was 85.29 years (range: 80–98). Technical success was achieved in 50 patients (92.6%). Mean IPSS improved from 18 at baseline to 7.7, 8.5, 8.6, and 9.1 at 6 months, 1, 2, and 3 years. Mean QoL improved from 4.9 at baseline to 2.8, 1.7, and 1.5 at 6 months, 1, and 2 years. Mean prostate volume reduced from a baseline of 152.7 to 123.5 mL within 6 months and 120.5 mL after 7 months of PAE. Urinary catheter removal was successful in 13 out of 19 patients with urinary retention. PAE succeeded in stopping bleeding in 16 out of 17 patients with prostate-induced hematuria. Conclusion PAE is a feasible low-risk treatment for LUTS with or without urinary retention or prostatic hematuria in elderly patients.

Abstract No. 67 Prostate artery embolization in patients with prostate glands greater than 80 g: a single-center experience with 5 years of follow-up

To evaluate the safety and efficacy of prostate artery embolization (PAE) for the treatment of symptomatic benign prostatic hyperplasia (BPH) for prostate glands greater than 80 g, a cohort of patients limited in management options given the size of the prostate

Abstract No. 514 Salvage prostate artery embolization in patients with refractory lower urinary tract symptoms following prior minimally invasive surgical technique for benign prostate hyperplasia

Minimally invasive surgical techniques (MIST) are alternatives to transurethral resection of the prostate (TURP) for treatment of Benign Prostatic Hyperplasia (BPH)1. However, a significant number of patients have persistent symptoms requiring further treatment. The efficacy of prostate artery embolization (PAE) following TURP for treatment of refractory lower urinary tract symptoms (LUTS) has been previously reported2,3. The purpose of this study was to report the safety and efficacy of PAE following MIST for refractory LUTS.

Clinical Outcomes of Prostatic Artery Embolization in Patients with Benign Prostatic Hyperplasia: A Prospective Clinical Study.

To determine the clinical outcomes of prostatic artery embolization applied to patients with Material and methods: The study includes 30 patients diagnosed with benign prostatic hyperplasia in the urology clinic between 2012 and 2016, for whom anesthesia was contraindicated due to advanced age and comorbidities and who underwent prostatic artery embolization. These patients were evaluated before the procedure and in the 1st, 3rd, 6th, and 12th months after the procedure. The mean prostate volume of the patients was 68 cm3 before the procedure and 45 cm3 12 monthsafter the procedure. A statistically significant decrease was observed (P = .001). The mean prostate-specific antigen value was 4.9 ng/dL before the procedure and 2.8 ng/dL 12 months after the procedure (P = .008). The mean Qmax value was 0 mL/s before the procedure and 12 mL/s 12 months after the procedure (P = .001). The mean international prostatic symptom scores value was 35 before and 16 twelve months after the proce-dure (P = .001). While the international index of erectile function value was 8.25 before the procedure, it was8.46 12 months after the procedure (P = .32). The quality of life index value was measured as 3.02 before theprocedure and 3.09 twelve months after the procedure; a statistically significant difference was determined (P = .027). Prostatic artery embolization, which is a minimally invasive procedure, can be applied as a safe and effective method to patients with benign prostatic hyperplasia who cannot tolerate anesthesia due to advanced age and comorbidities.

Genicular artery embolization as a novel treatment for mild to moderate knee osteoarthritis: protocol design of a randomized sham-controlled clinical trial

IntroductionKnee osteoarthritis is a common disease with pain as the most prevalent symptom. Previous cohort studies have shown genicular artery embolization to reduce pain symptoms in patients with mild to moderate knee osteoarthritis. Patients resistant to conservative therapy but not eligible yet for surgical treatment due to young age or comorbidities may profit from an effective and sustained pain reduction treatment. This study is a randomized sham-controlled trial to evaluate the efficacy of genicular artery embolization in patients with knee osteoarthritis.Methods and analysisFifty-eight patients with mild-to-moderate knee osteoarthritis will be recruited and randomly allocated to the treatment or control group in a 1:1 ratio. Participants in the treatment group will undergo genicular artery embolization. Patients in the control group will undergo sham treatment. Outcome measurements will be assessed at baseline and after 1, 4, 8, and 12 months with questionnaires, pressure pain threshold testing, and MR imaging. The MR imaging protocol is designed to (semi)quantitatively assess osteoarthritis in the knee joint. The primary outcome is the change from baseline of the Knee injury and Osteoarthritis Outcome Score (KOOS) pain subscale after 4 months. Secondary outcomes include change in osteoarthritis-related questionnaires, pressure pain threshold, and OA-related MRI features, particularly synovitis and bone marrow lesions.Ethics and disseminationThis trial will determine the efficacy of genicular artery embolization compared to a sham treatment. This is of importance to assess before proceeding to larger-scale efficiency studies and, ultimately, implementing this treatment into day to day clinical practice.Trial registrationClinicalTrials.gov NCT03884049. Registered on 21 March 2019

Temporary Internal Iliac Artery Blockage versus Uterine Artery Embolization in Patients After Laparoscopic Pregnancy Tissue Removal Due to Cesarean Scar Pregnancy.

ObjectiveThis study aims to evaluate the clinical value of laparoscopic temporary internal iliac artery blockage (TIIAB) compared with uterine artery embolization (UAE) in type III cesarean scar pregnancy (CSP).MethodsA total of 76 patients with type III CSP admitted to the Department of Gynecology the First Affiliated Hospital of Zhengzhou University between September 2017 and June 2019 were selected for this retrospective study. Thirty-six of them in the study group received TIIAB, and the rest in control group received UAE. Laparoscopic pregnancy tissue was removed from all patients, and the uterine defects were repaired. The absence of remnants was then confirmed using ultrasonography. Follow-ups were performed in the two groups for six months, and the factors of intraoperative blood loss, operation and menelipsis time, 24-h human chorionic gonadotropin decline rate, postoperative complications, hospitalization days, hospitalization costs, peri-operative hormone levels, and ovarian function indicators were compared between the two groups and within each group.ResultsThere were statistically significant differences in the hospitalization cost, menelipsis time, and postoperative complication incidence between the two groups (p < 0.05). There were statistically significant differences between ovarian function at one month and three months after surgery (p < 0.05) as well as among the follicle-stimulating hormone, luteinizing hormone, and estradiol levels at one, three, and six months after surgery in the control group (p < 0.05).ConclusionCompared with uterine artery embolization, laparoscopic TIIAB has the advantages of a low hospitalization cost, lower postoperative complication rate, and shorter menelipsis time. Moreover, it avoids ovarian function damage. It is a safe method worthy of clinical popularization.

Genicular Artery Embolization: Beyond the Placebo Effect, and Planning for the Long Road Ahead

Genicular artery embolization (GAE) has emerged in the field of interventional radiology as a treatment for knee pain related to osteoarthritis. This novel treatment is based on the hypothesis by Okuno et al and supported by multiple small single-arm studies ( 1 Okuno Y. Korchi A.M. Shinjo T. et al. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis. Cardiovasc Intervent Radiol. 2015; 38: 336-343 Crossref PubMed Scopus (50) Google Scholar , 2 Okuno Y. Korchi A.M. Shinjo T. et al. Midterm clinical cutcomes and MR imaging changes after transcatheter arterial Embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. J Vasc Interv Radiol. 2017; 28: 995-1002 Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar , 3 Lee S.H. Hwang J.H. Kim D.H. et al. Clinical outcomes of transcatheter arterial embolisation for chronic knee pain: mild-to-moderate versus severe knee osteoarthritis. Cardiovasc Intervent Radiol. 2019; 42: 1530-1536 Crossref PubMed Scopus (40) Google Scholar , 4 Landers S. Hely R. Page R. et al. Genicular artery embolization to improve pain and function in early-stage knee osteoarthritis-24-month pilot study results. J Vasc Interv Radiol. 2020; 31: 1453-1458 Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar , 5 Bagla S. Piechowiak R. Hartman T. et al. Genicular artery embolization for the treatment of knee pain secondary to osteoarthritis. J Vasc Interv Radiol. 2020; 31: 1096-1102 Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar , 6 Little M.W. Gibson M. Briggs J. et al. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the knee (GENESIS) using permanent microspheres: interim analysis. Cardiovasc Intervent Radiol. 2021; 44: 931-940 Crossref PubMed Scopus (26) Google Scholar ) that pain is in part due to hypervascularity and inflammation, but several considerations need to be addressed. These include GAE's indications, mode of action, mechanism of clinical success achieved by short-term embolization using imipenem/cilastatin crystals vs other embolics, and the possibility of symptom improvement due to the placebo effect. In particular, concern about the placebo effect is plausible given that embolization using imipenem/cilastatin crystals, which are smaller and more rapidly soluble than typical embolic materials ( 7 Yamada K. Jahangiri Y. Li J. et al. Embolic characteristics of imipenem-cilastatin particles in vitro and in vivo: implications for transarterial embolization in joint arthropathies. J Vasc Interv Radiol. 2021; 32: 1031-1039.e2 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar ), have yielded outcomes similar to those of permanent embolic materials ( 2 Okuno Y. Korchi A.M. Shinjo T. et al. Midterm clinical cutcomes and MR imaging changes after transcatheter arterial Embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. J Vasc Interv Radiol. 2017; 28: 995-1002 Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar ). Osteoarthritic pain response is also highly susceptible to the placebo effect ( 8 Doherty M. Dieppe P. The “placebo” response in osteoarthritis and its implications for clinical practice. Osteoarthritis Cartilage. 2009; 17: 1255-1262 Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar ). Therefore, a sham-controlled study is extremely valuable to assess the efficacy of GAE. However, it is difficult to justify a sham-controlled study in the field of interventional radiology because subjects in the control arm would be at risk of adverse events that may not be trivial, such as infection or bleeding after arterial access.

Preoperative MRI Classification May Not Predict Symptom Relief after Uterine Artery Embolization in Patients with Adenomyosis.

To investigate the association between magnetic resonance imaging (MRI) classification and symptom relief after uterine artery embolization (UAE) in patients with adenomyosis. Totally, 73 patients with symptomatic adenomyosis who underwent UAE were retrospectively analyzed. Preoperative MRI classification was defined as: type I, high signal on both T2-weighted images (T2WI) and T1-weighted images (T1WI); type III, high signal only on T2WI, and type II, high signal on neither T1WI nor T2WI. Dysmenorrhea was measured with the visual-analog scales and the degree of menorrhagia was measured according to the number of sanitary pads used in one menstrual cycle. Dysmenorrhea and menorrhagia were measured before UAE and 12 months after UAE. The number of the type I, II, III cases was 23, 37, and 13, respectively. The baseline characteristics of the three groups exhibited no significant difference. The alleviation rates of dysmenorrhea among type I, II, III cases were 73.9%, 89.2%, and 84.6%, respectively (P=0.455). The alleviation rates of menorrhagia for type I, II, III were 69.6%, 78.4%, and 92.3%, respectively (P=0.714). Pre-procedure MRI classification and symptom relief after UAE exhibited no significant association. UAE has a favorable mid-term control on dysmenorrhea and menorrhagia among patients with adenomyosis. Preoperative MRI classification might not indicate symptom relief. More research is needed before changing clinical practice.

Investigation and Analysis of Influencing Factors of Moderate to Severe Pain After Uterine Artery Embolization in Patients with Cesarean Scar Pregnancy.

ObjectiveTo investigate the occurrence and influencing factors of moderate to severe pain in patients with cesarean scar pregnancy (CSP) after uterine artery embolization (UAE).MethodsNinety-eight patients with CSP who underwent UAE in gynecology department of the Fujian Medical University Union Hospital from January 2017 to December 2020 were enrolled, and the specialty data in patients were collected for pain assessment with the adoption of the numerical rating scale (NRS).ResultsModerate to severe pain occurred in 36 patients after surgery, and the interquartile of time to the first onset of postoperative pain in patients was 3.04 (1.75, 7.40) hours. The number of pregnancies, number of miscarriages, human chorionic gonadotropin (HCG) before curettage, duration of medication before UAE, and hemorrhage after UAE were not significantly correlated with the occurrence of moderate to severe pain after UAE (P > 0.05). The volume of gestational sac and days of gestation were responsible for the occurrence of moderate to severe pain after UAE (P < 0.05), with the former being the main influencing factor, and these explained 8.3% of the total variance.ConclusionModerate to severe pain occurred commonly in patients with CSP undergoing UAE. In clinical care of patients with CSP who are going to undergo UAE, data concerning the volume of gestational sac and days of gestation should be considered for anticipatory pain assessment, and interventions should be implemented as early as possible to reduce the pain and improve the experience of care.

P12‐23: Bronchial artery embolization in patients with hemoptysis: self‐assessed patents satisfaction with treatment, efficacy, safety, and quality of life

P12‐23: Bronchial artery embolization in patients with hemoptysis: self‐assessed patents satisfaction with treatment, efficacy, safety, and quality of life

Feasibility and outcomes of bronchial artery embolization in patients with non-massive hemoptysis

PurposeTo evaluate the safety, efficacy, and long-term outcome of bronchial artery embolization (BAE) in the treatment of non-massive hemoptysis and the prognostic factors associated with recurrent bleeding.Materials and methodsFrom March 2005 to September 2014, BAE was performed in 233 patients with non-massive hemoptysis. All patients had a history of persistent or recurrent hemoptysis despite conservative medical treatment. We assessed the technical and clinical success, recurrence, prognostic factors related to recurrent bleeding, recurrence-free survival rate, additional treatment, and major complications in all the patients.ResultsTechnical success was achieved in 224 patients (96.1%), and clinical success was obtained in 219 (94.0%) of the 233 patients. In addition, 64 patients (27.5%) presented hemoptysis recurrence with median time of 197 days after embolization. Tuberculosis sequelae and presence of aberrant bronchial artery or non-bronchial systemic collaterals were significantly related to recurrent bleeding (p < 0.05). The use of Histoacryl-based embolic materials significantly reduced the recurrent bleeding rate (p < 0.05). Patient who had a tuberculosis sequelae showed a significantly lower recurrence-free survival rate (p = 0.013). Presence of aberrant bronchial artery or non-bronchial systemic collaterals showed a statistically significant correlation with recurrence-free survival rate (p = 0.021). No patients had major complications during follow-up.ConclusionsBAE is a safe and effective treatment to manage non-massive hemoptysis. The procedure may offer a better long-term control of recurrent hemoptysis and quality of life than conservative therapy alone.

Clinical investigation of fertility after uterine artery embolization

Uterine artery embolization is an effective and safe technique for the treatment of uterine fibroids, but its use remains controversial for women who wish to procreate. This study aimed to study the clinical, anatomic, and obstetrical results of uterine artery embolization in patients of childbearing age not eligible for myomectomy. This was a retrospective cohort study of 398 female patients under the age of 43 years who were treated by uterine artery embolization between 2003 and 2017 for symptomatic fibroids and/or adenomyosis. Uterine artery embolization was performed according to a standardized procedure (fertility-sparing uterine artery embolization technique), with ovarian protection in the event of dangerous utero-ovarian anastomosis. Magnetic resonance imaging and pelvic ultrasounds were performed before and after uterine artery embolization. The overall clinical success rate (ie, resolution of preembolization symptoms such as heavy menstrual bleeding, iron-deficiency anemia, pelvic pressure) was 91.2%, and there were no major complications. One year after uterine artery embolization, we observed a mean 73% reduction in myoma volume. A total of 108 patients (49.3%) presented with dangerous utero-ovarian anastomosis and 33 (14.5%) benefited from ovarian protection. In our group, there were 148 pregnancies and 109 live births; 74 children were born at term; 23 were born preterm, on average at 35.12±2.78 weeks. Including preterm births, the mean birthweight and birth length of the children were within normal limits. Restoration of uterine anatomy and ovarian protection were identified as the main predictive factors for obstetrical success. Restoration was also a major predictive factor for clinical success and was associated with a lower rate of miscarriage. This study provided detailed clinical and obstetrical outcomes for 398 female patients who underwent uterine artery embolization for fibroid treatment; it contributes to the identification of anatomic and technical factors that could have an impact on fertility after uterine artery embolization. Further controlled clinical trials are needed to confirm our findings and reevaluate this procedure's indications and limitations for women with a desire to procreate.

Perioperative Blood Loss after Preoperative Prostatic Artery Embolization in Patients Undergoing Simple Prostatectomy: A Propensity Score‒Matched Study

PurposeTo assess perioperative blood loss following prostatic artery embolization (PAE) before surgery in patients undergoing simple prostatectomy. MethodsA retrospective chart review was used to identify 63 patients (mean age, 65.3 ± 8.0 years) with prostatic hypertrophy and severe lower urinary tract symptoms who underwent prostatectomy from September 2014 to December 2019, 18 (28.5%) of whom underwent PAE before surgery. Demographic data, pertinent laboratory results, procedural or operative information, hospital course details, and pathology reports were obtained. A 2:1 propensity score‒matching analysis was performed to compare intraoperative blood loss in patients who underwent prostatectomy alone with intraoperative blood loss in those who first underwent bilateral PAE before surgery. ResultsSixteen (89%) of the 18 patients underwent bilateral PAE before surgery. Thirty-two patients who underwent prostatectomy without embolization before surgery were selected for the 2:1 propensity score‒matched analysis based on age, race, surgery type, prostate gland size, and comorbidities. The mean estimated blood loss (EBL) for prostatectomy alone was 545 ± 380 mL (mean ± standard deviation). There was a statistically significant reduction in the EBL for patients who underwent bilateral PAE (303 ± 227 mL, P < .01). The operative time was also significantly decreased for patients who underwent PAE before surgery (P < .05). For patients who underwent PAE, there were no complications related to the procedure. ConclusionsBilateral PAE before surgery appears to be safe and may be effective in reducing perioperative bleeding and operative time.

Abstract No. 538 Unilateral versus bilateral prostatic artery embolization in patients with benign prostatic hyperplasia: an officed-based laboratory experience using mobile C-arm

This study was designed to look at the efficacy of unilateral compared to bilateral prostatic artery embolization for the treatment of benign prostatic hyperplasia in an office-based laboratory. While data exists showing that bilateral prostatic artery embolization is superior to unilateral embolization, there is a lack of data showing this in an office-based laboratory where a fixed fluoroscopy unit is not typically available. A review of 111 patients who underwent prostate artery embolization were reviewed. Information on whether unilateral or bilateral PAE was performed, success rates of PAE and IPSS scores 1-month post-procedure were gathered. Additionally, if unilateral PAE was performed, reasons for conducting unilateral compared to bilateral PAE was also noted. All procedures were performed with a GE OEC 9800 C-arm system. Of the patients found, 88 patients underwent bilateral PAE while 23 underwent unilateral PAE. All PAEs were conducted by a single provider. Unilateral PAE was technically successful in 89% of cases while bilateral PAE was successful in 94% of cases. There was a larger reduction in IPSS scores in bilateral PAE compared to unilateral PAE. The most common reason for conducting unilateral PAE over bilateral PAE was due to lack of visualization of vessels of both prostatic arteries. This was the first study looking at bilateral versus unilateral PAE using mobile C-arm units. Results were similar to studies investigating bilateral and unilateral PAE using a fixed fluoroscopy unit. While many studies note that cone-beam computed tomography is a necessary requirement for the successful performance of PAE, this study may indicate that mobile fluoroscopy units alone can be used for PAE.

Abstract No. 39 Prostatic artery embolization in patients with recurrent lower urinary tract symptoms following failed transurethral resection of the prostate

This study examines the safety and efficacy of prostatic artery embolization (PAE) in treating benign prostatic hyperplasia (BPH) with refractory lower urinary tract symptoms (LUTS) following transurethral resection of the prostate (TURP).

Abstract No. 15 Two-year outcomes of comparing Embosphere microspheres versus imipenem–cilastatin for genicular artery embolization in patients with knee osteoarthritis

Genicular artery embolization (GAE) has potential to provide midterm relief of pain for patients with mild-to-moderate knee osteoarthritis resistant to conservative management. The study compares use of trisacryl gelatin microspheres (ES) to imipenem-cilastatin (IMP/CS) particles for GAE on a cohort of patients with two-year of clinical follow-up. In a prospective study, a total of ten patients (15 knees) who had GAE with 100-to 300-μm ES particles were compared with a subsequent cohort of eleven patients (18 knees) who underwent GAE with IMP/CS. Clinical outcomes were evaluated at 6-month and 24-month follow-up and compared to baseline using WOMAC questionnaire. There was no significant difference in sex, age, BMI, duration of pain before the procedure, prior treatment, or Kellgren-Lawrence grade between the 2 cohorts. Baseline median pain WOMAC and total WOMAC scores were 13 (IQR 4) and 46 (IQR 4) in the ES group and 13 (IQR 3) and 47 (IQR 28) in the IMP/CS groups (P = 0.875 and P = 0.738), respectively. The median follow-up was 796 days (range, 736-808). Clinical success (50% reduction in WOMAC pain score vs baseline) was achieved in 69.23% of the embolized knee joints in both groups (P = 1.0) at 6 months, and 61.5% versus 53.8% of in ES and IMP/CS groups, at 2-years of follow-up, respectively (P = 1.0). Both embolic materials resulted in significant decrease in Pain WOMAC and Total WOMAC scores at 6 months (compared to baseline) (P< 0.05) and the effect of GAE on Pain WOMAC and Total WOMAC scores was sustained until the 24-month follow-up visit in both groups (P< 0.05). Minor events included transient cutaneous color change (five patients) or transient leg numbness (one patient) and was only identified after GAE with ES particles (P = 0.00387), which resolved spontaneously at 1-month follow-up (Clavien-Dindo classification grade I). There was no major adverse event. 100- to 300-μm ES particles can be considered for GAE and is comparable to IMP/CS in pain reduction of moderate to severe knee osteoarthritis and with sustained effect up to two-years of follow-up.

Abstract No. 567 Prostatic artery embolization in patients with prior prostatitis

Prostatic artery embolization (PAE) is an elective procedure to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Studies have shown that a prior diagnosis of prostatitis is associated with an increased likelihood of developing BPH (1). This report examines technical and clinical outcomes for BPH patients with prior prostatitis who undergo PAE. All consecutive elective PAEs conducted at 2 hospitals in a tertiary academic health system from June 2014 to August 2020 were collected (n = 216). Patients were included in this study if they had a history of prostatitis prior to elective PAE. For patients meeting these inclusion criteria, demographic, baseline, procedural, and follow-up data were collected by review of electronic medical records. Of the 216 patients receiving elective PAEs queried, nine had prior prostatitis. The mean age of the patients at the time of the procedure was 68.8 years (SD = 16.2). Five patients had a history of acute bacterial prostatitis, three had chronic prostatitis, and one had radiation prostatitis. For eight patients, the date of their most recent episode of prostatitis was available and was an average of 1.9 years before their procedure (SD = 2.4). Procedures had a mean fluoroscopy time of 33.2 minutes and radiation dose of 600752.9 mGycm2. Technical success, defined as bilateral stasis, was achieved in seven of nine procedures. In the other two patients, unilateral embolization was accomplished in one patient, and bilateral failure occurred in one patient. The failures occurred due to the presence of an accessory vessel in one patient, and a double right-angle origin of the prostatic artery bilaterally in the other patient. Two of nine patients presented with hematuria and underwent PAE in an emergent setting, whereas seven patients presented with BPH and LUTS and underwent the procedure in an outpatient setting. Patients with follow-up were evaluated at an average of 71 days post-operatively (SD = 50.7) and experienced a mean reduction in International Prostate Symptom Score of 10.3 (n = 4, SD = 15.1) and a mean reduction in Quality of Life Score of 1.3 (n = 4, SD = 1.5). Prostatitis can increase risk for development of BPH. This initial study demonstrated the feasibility of PAE in patients with prior prostatitis. Further investigation is warranted to determine the impact of a history of prostatitis on the outcomes of PAE.

Outcomes and complications of uterine artery embolization in patients with cervical ectopic pregnancy and ectopic pregnancies caused by surgical incision

Outcomes and complications of uterine artery embolization in patients with cervical ectopic pregnancy and ectopic pregnancies caused by surgical incision

108 Erectile Function Following Prostate Artery Embolization in Patients with Larger Prostate Glands: A Large Single Center Experience

Prostate artery embolization (PAE) is an emerging therapy for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH), particularly for those men who have larger prostate glands. Our center has developed one of the largest PAE programs, finding that this technology effectively reduces symptom burden, improves urodynamic parameters, and decreases prostate size. Although a number of prior studies have reported sexual function as an outcome measure following PAE, most have not yet focused explicitly on sexual function. This retrospective study was conducted to assess the effect of PAE on erectile dysfunction (ED) as assessed by the Sexual Health Inventory for Men (SHIM) questionnaire at 3 months following the procedure.