Comparing the Efficacy of Prostate Artery Embolization in Patients with Small versus Large Volume Benign Prostatic Hyperplasia

Tuesday, April 1, 2025

3:09 PM – 3:18 PM CT

Location: Music City Center, 204

Presenting Author(s)

Kiyon Naser-Tavakolian, MD

Assistant Professor Interventional Radiology
Columbia University, United States

Author/Co-author(s)

Abin Sajan, MD

Resident
Columbia Irving Medical Center, United States
Connie Liou, MD

Resident Physician
Columbia University, United States
SF

Samuel Fordyce, MD

Resident Physician
Columbia University, United States
GA

Gbenga Adeyeye, DO

Radiology Resident
Atlantic Health Morristown Medical Center, United States
Asad Baig, MD

Assistant Professor Interventional Radiology
Columbia University, United States
SR

Stephen P. Reis, MD

Associate Professor Interventional Radiology
Columbia University, United States
Raghuram Posham, MD

Assistant Professor
NewYork Presbyterian - Columbia University, United States

Purpose:

Prostate Artery Embolization (PAE) is an accepted treatment for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). The purpose of this study is to compare the efficacy of PAE in small versus large volume prostate glands.

Materials and Methods:

This was an IRB approved retrospective study of 178 PAE patients from February 2020 to May 2024. Patients were assessed with the International Prostate Symptom Score (IPSS) pre and post procedure. Patients had pre-procedure imaging (ultrasound, CT, or MRI) measuring gland size and post procedure imaging between 1 and 12 months to evaluate gland size. Group A had prostate sizes < 61g (N = 29) and group B had prostates >61g (N = 149). Follow up was performed at 1, 3, and either 6 or 12 months.

Results:

No significant differences between baseline age or IPSS score between the two groups (mean age 69.7, IPSS 22.3, n = 178). Initial prostate volumes for group A was 48.4g (+/- 8.3), n = 29. Group B was 143.1g (+/-81.9), n = 149. Technical success was noted in 97% in group A and 91% in group B. 6/149 had unilateral embolizations and the remaining failures in both groups were due to atherosclerosis. There was a statistically significant reduction in IPSS. Significant post-treatment differences in IPSS was noted in Group A (24.6 to 10.2, p< 0.00001) and B (21.7 to 7.1, p< 0.0001). Similar prostate size reductions were present in both Groups A (p = 0.17) and B (p < 0.0001). No major adverse events were reported.

Conclusion:

Our results add to the existing literature and confirm the effectiveness of PAE in patients with smaller glands. The ability to target smaller glands presents a unique advantage over existing minimally invasive surgical options.