Prostate Artery Embolization - Mid to Long-term Outcomes in 1075 Patients.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology Pub Date : 2024-11-10 DOI:10.1016/j.jvir.2024.11.002

Shivank Bhatia, Ansh Bhatia, Andrew J Richardson, Kenneth Richardson, Chloe Issa, Jessica G Kumar, Hamed Jalaiean, Bruce Kava, Hemendra N Shah

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引用次数: 0

Abstract

Background: To assess the mid to long-term safety and efficacy of Prostatic Artery Embolization (PAE) at a single-center, cohort of 1075 patients.

Methods: This IRB-approved retrospective-study included patients with moderate-to-severe Lower-Urinary-Tract-Symptoms(LUTS) or urinary-retention who underwent PAE from January-2014 to July-2023. Patients were assessed at 1, 3, 6, and 12-months post-PAE and yearly thereafter. International-Prostate-Symptom-Score(IPSS), Quality-of-Life(QoL) score, International-Index of Erectile-Function-5 score(IIEF-5), Prostate-Specific-Antigen(PSA), Prostate-volume(PV), Post-void-Residual(PVR), Benign-Prostatic-Obstruction(BPO)-medication usage, urinary-catheter status, and further prostate-interventions were assessed. Adverse-events were recorded and classified using the Society of Interventional-Radiology Adverse-Events(SIR-AE) severity classification.

Results: The mean follow-up was 458.4±559.5 days. Mean age was 70.4±9.0 years, median(IQR) prostate-volume was 107gm(76-150), median pre-procedure IPSS, QoL, IIEF-5, and PSA were 23(18-28), 5(4-6), 17(10-21), and 4.7(2.6-8), respectively. In the LUTS subgroup, at 1-3, 6-12, and 48-60 months, the median-IPSS was 7(4-12, p<0.001), 6(3-11, p<0.001), and 9(4-15, p<0.001). The QoL was 2(1-2, p<0.001), 1(0-2, p<0.001), 2(0-3, p<0.001) at the same time-points. 119(94%) out of 126-patients in the retention cohort were catheter-free at the 3-month follow-up. Ninety-patients(16% of re-intervention eligible patients) required a second prostatic-intervention upto 60-months post-PAE. 65.5% of patients post-PAE were BPO-medication-free at 1-year. 7 patients (0.65%) had SIR-AE severity-Severe: transient ischemic-attacks:3, Urosepsis-2 (treated in inpatient-setting with IV-antibiotics), prostate-sloughing-2(needing TURP). All adverse events resolved without sequelae.

Conclusion: In a large cohort with long-term longitudinal follow-up, PAE shows significant, sustained long-term relief of LUTS, improved QoL, low re-intervention rate, and high BPO medication-free rates. 94% of catheter-dependent patients at baseline were catheter-free at 3-months.

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前列腺动脉栓塞术 - 1075 例患者的中长期疗效。

背景：评估前列腺动脉栓塞术（PAE）的中长期安全性和有效性：目的：评估单中心 1075 例前列腺动脉栓塞术（PAE）的中长期安全性和有效性：这项经 IRB 批准的回顾性研究纳入了 2014 年 1 月至 2023 年 7 月期间接受 PAE 的中重度下尿路症状（LUTS）或尿潴留患者。患者在 PAE 术后 1、3、6 和 12 个月接受评估，此后每年接受一次评估。评估内容包括国际前列腺症状评分（IPSS）、生活质量评分（QoL）、国际勃起功能指数-5评分（IIEF-5）、前列腺特异性抗原（PSA）、前列腺体积（PV）、排尿后残余尿量（PVR）、良性前列腺梗阻（BPO）用药情况、导尿管状态以及其他前列腺干预措施。对不良事件进行记录，并采用介入放射学不良事件（SIR-AE）严重程度分类法进行分类：平均随访时间为 458.4±559.5 天。平均年龄（70.4±9.0）岁，前列腺体积中位数（IQR）为107gm（76-150），术前IPSS、QoL、IIEF-5和PSA的中位数分别为23（18-28）、5（4-6）、17（10-21）和4.7（2.6-8）。在 LUTS 亚组中，1-3、6-12 和 48-60 个月的 IPSS 中位数分别为 7（4-12，p）：在一个长期纵向随访的大型队列中，PAE能显著、持续地长期缓解LUTS，改善QoL，降低再次干预率，提高无BPO药物治疗率。94%的基线导管依赖患者在3个月后不再使用导管。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.