SIR 2024
Men's Health
Jade Lerner, MD (she/her/hers)
Resident
Rutgers New Jersey Medical School
Financial relationships: Full list of relationships is listed on the CME information page.
Adam Geffner, BA (he/him/his)
Medical Student
Icahn School of Medicine at Mount Sinai
Financial relationships: Full list of relationships is listed on the CME information page.
Vivian Bishay, MD
IR
Mount Sinai Hospital System
Financial relationships: Full list of relationships is listed on the CME information page.
Kirema Garcia-Reyes, MD
Assistant Professor
Mount Sinai
Financial relationships: Full list of relationships is listed on the CME information page.
Dan Shilo, MD
Assistant Professor, Diagnostic, Molecular and Interventional Radiology
Mount Sinai Hospital
Disclosure information not submitted.
Aaron M. Fischman, MD, FSIR, FCIRSE, FSVM
Professor, Diagnostic, Molecular and Interventional Radiology
Icahn School of Medicine at Mount Sinai
Disclosure information not submitted.
Prostatic artery embolization (PAE) using microparticles (mp) has proven effective in managing hematuria of prostate origin, with common etiologies including benign prostatic hyperplasia, malignancy, and trauma. However, concerns about radiation exposure have emerged due to procedural complexity (1-3). n-Butyl cyanoacrylate (n-BCA) is an alternative embolic agent offering enhanced procedural efficiency and improved durability (4-5). This study aims to compare the safety and clinical efficacy of n-BCA-PAE and mp-PAE for treating prostatic hematuria.
Materials and Methods:
A retrospective review was conducted for patients who underwent n-BCA-PAE for prostatic hematuria from 6/2022-7/2023. n-BCA-PAE via trans-radial access was performed with a 1:10 n-BCA:lipiodol mixture. Technical success (bilateral PAE), clinical success (resolution of hematuria), and adverse events were recorded. Radiation parameters, including dose area product and fluoroscopy time were recorded. For valid comparison, patients were age- and prostate volume-matched with the published literature for patients treated with mp-PAE for prostatic hematuria.
Results:
Of 123 embolizations performed, 64 patients presented with preoperative hematuria and were included in the analysis. Mean age at embolization was 72 (54-93), and mean preoperative prostate volume was 168 mL3 (32-502). Technical success was 97%. No major adverse events were reported. The mean FT in the n-BCA group (26.1±13.3 min) was significantly reduced compared to the mp group (46.3±21.7, p< 0.0001). Clinical success was 87% at 10-week follow-up in the n-BCA group (N=55) compared to 88% at 3-month follow-up in the mp group (N=97).
Conclusion:
n-BCA-PAE for hematuria of prostate origin offers a similar safety profile and clinical outcomes to published mp-PAE data. Notably, patients embolized with n-BCA showed significantly reduced FT compared to mp-PAE.