SIR 2024
Embolization
Ajay Varadhan, BS
Northwestern Interventional Radiology Research Fellow and Medical Student
Northwestern University Feinberg School of Medicine, Chicago, IL
Financial relationships: Full list of relationships is listed on the CME information page.
Piyush Goyal, BS
Medical Student
Northwestern University Feinberg School of Medicine, Chicago, IL
Disclosure information not submitted.
Elias Hohlastos, MD
Professor
Northwestern University Feinberg School of Medicine
Disclosure information not submitted.
Kimberly Jenkins, n/a
Patient Care Coordinator
Northwestern Memorial Hospital
Disclosure information not submitted.
Riad Salem, MD, FSIR, MBA
Professor
Northwestern Memorial Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
Samdeep Mouli, MD
Associate Professor
Northwestern University Feinberg School of Medicin
Financial relationships: Full list of relationships is listed on the CME information page.
Prostate artery embolization (PAE) is a nonsurgical, minimally invasive procedure utilized in treatment of benign prostatic hyperplasia (BPH). In general, clinical outcomes have shown to be dependent on socioeconomic status (SES), however this has not been reported in PAE. Prior studies report that the prevalence of BPH and resulting symptoms are affected by factors including race and occupation {1,3}. Here, we report the effects of patient SES, based upon area deprivation index (ADI), on clinical outcomes in PAE patients.
Materials and Methods:
204 PAE patients were retrospectively analyzed from January 2020 to August 2023. PAE was performed using standard techniques, including 300-500 micron particles for bilateral embolization. Patients were followed at 1, 3, 6, and 12 months post-treatment. Patients were classified by ADI, which reflects SES deprivation based on the zip code of residence. A cut-off of 50th percentile differentiated “Advantaged” or “Disadvantaged” groups. International Prostate Symptom (IPSS), Quality of Life (QoL), Benign Prostatic Hyperplasia Impact Index (BPH-II), and Male Sexual Health questionnaire (MSHQ-EjD) were compared between groups with linear regression with p≤0.05 as significant.
Results:
Patients were classified as Advantaged (n=44) or Disadvantaged (n=149) with 11 patients unable to be categorized and excluded (Table 1). All cases were technically successful. The mean IPSS score for all patients before and after PAE was 23.10 ± 6.13 and 10.07 ± 7.50, respectively (p < 0.05). Linear regressions comparing ADI vs. IPSS, QoL, and BPH-II demonstrated no significant reduction of scores for Advantaged patients compared to Disadvantaged patients (p> 0.05). Linear regressions comparing ADI vs. MSHQ scores were not significant between groups (p >0.05).
Conclusion:
Socioeconomically Advantaged and Disadvantaged patients undergoing PAE for LUTS demonstrated significant improvements in outcome scores compared to Disadvantaged patients. Socioeconomic barriers may contribute to clinical outcomes following PAE. This data emphasizes the benefit of studying healthcare access, evidence-based management, and neighborhood-level factors to overcome barriers with respect to post-operative outcomes after PAE.