148 - Prostate Artery Embolization in Catheter-Dependent Patients: Efficacy, Safety, and Lessons Learned from a Large-Cohort Single-Center Experience

Monday, April 13, 2026

4:21 PM - 4:30 PM ET

Presenting Author(s)

MN

Monika Neale, DO

Resident
Division of Interventional Radiology, Imaging Institute, Cleveland Clinic, United States

Author/Co-author(s)

LW

Logan Worley, MD

Resident
Division of Interventional Radiology, Imaging Institute, Cleveland Clinic, United States
SD

Smita De, MD

Staff Physician, Department of Urology
Cleveland Clinic, United States
SL

Susan Luay, MD

Staff physician
Cleveland Clinic, United States
IH

Ihab Haddadin, MD

Staff Physician
Cleveland Clinic Foundation, United States
Justin J. Guan, MD

Associate Staff Physician
Cleveland Clinic, United States
Sameer Gadani, MD, FSIR

Associate Professor and Staff
Cleveland Clinic Foundation , United States
VC

Vishu Chandrashekhar, BS

medical student
Cleveland Clinic, United States
HY

Haitong Yu, BS

Medical student
Cleveland Clinic, United States
Amrit Khooblall, MBA

Student
Division of Interventional Radiology, The Cleveland Clinic Imaging Institute, United States

Purpose: Assess the efficacy of prostate artery embolization (PAE) in patients with short and long term urinary
retention with indwelling catheter.

Materials and Methods: The first stage of this IRB-approved retrospective cohort study included 59 catheter-dependent patients (pts) who underwent PAE between 2015 and 2025 for urinary retention with indwelling catheter. All pts referred to IR with indwelling catheter were included, irrespective of catheter duration or prior non IR therapy. Preprocedural data included demographics, prostate volume, catheter type/duration, bladder outlet obstruction index (BOOI), and pharmacologic treatment. Procedural parameters (embolization technique, fluoroscopy time, radiation dose) were recorded with technical success (TS) defined as bilateral embolization and clinical success (CS) as a successful voiding trial without catheter (TWOC). Post-procedural data collection included time to successful TWOC, number of TWOC required, medication adjustments, and complications. Regression analysis was used to evaluate predictors (baseline prostate size, catheter duration/type, embolization technique/success) against outcomes: successful TWOC, time interval between PAE and catheter removal, as well as trends in adjunct medication needs.

Results: Fifty-nice catheter-dependent pts (mean age 76.3 ± 8.4 years) were included in the preliminary analysis. Technical success was achieved in 88% (52/59).unsuccessful procedures include only unilateral embolization of 2 patients (3%) and incomplete bilateral embolization in 4 patients (6%). CS achieved in 36 patients (69%), with the majority (54%) succeeding on first TWOC. Time to successful TWOC was: 8 (22.2%) < 4 wks, 14 (38.8%) within 4–6 wks, 4 (11.1%) between 6–11 wks, and 10 (27.8%) ≥12 wks. TWOC attempts were: 28 pts (77.7%) had 1 , 5 pts (13.8%) had 2, 1 pt (2.7%) 3, and 2 pts (5.5%) had 4 attempts. Pharmacological therapy was discontinued in 15 pts (25%) following PAE. Mean follow up was 12 months with no relapse. Prostate size, catheter duration, and urodynamic (UDS) findings did not significantly predict outcomes. Ongoing analysis of an expanded cohort (N=90) will evaluate IPSS score trajectories and medication requirements.

Conclusion: PAE demonstrates high clinical success in patients with short and long-term urinary retention with
indwelling catheters, irrespective of duration of indwelling catheter.