Comparison of 24-Month Clinical Outcomes after Prostatic Artery Embolization in Prostate Glands Larger versus Smaller than 80 mL: A Systematic Review

J Vasc Interv Radiol. 2023 Apr;34(4):578-584.e1. doi: 10.1016/j.jvir.2022.11.025. Epub 2022 Dec 5.

Abstract

Purpose: This review was undertaken to compare the clinical outcomes of prostatic artery embolization (PAE) in patients with >80 versus <80 mL prostatic volume (PV) at the 24-month follow-up to determine whether PV predicted the effectiveness or durability of PAE.

Materials and methods: The PubMed/MEDLINE database was searched for articles published between 2010 and 2022 using the search term "(prostat∗ artery embolization) AND (long term OR follow-up OR 24-month)." Articles were included if they discussed PAE for benign prostatic hyperplasia (BPH) and reported a minimum follow-up of 24 months. Articles with <10 patients were excluded. A subgroup analysis was performed to evaluate for any difference in clinical outcomes at the 24-month post-PAE follow-up between studies with a mean PV of >80 mL and those with a mean PV of <80 mL.

Results: A total of 14 studies with 2,260 patients were included, all of which demonstrated significant reduction in symptoms at the 24-month follow-up after PAE. Four studies were included as part of the >80-mL PV subgroup (n = 467), and 10 studies were included as part of the <80-mL PV subgroup (n = 1,793). There was a statistically significant difference between the mean preprocedural PV (128.5 vs 64.0 mL; P = .015). At the 24-month follow-up, there were no significant differences between groups across any of the compared parameters. The collective incidence of major adverse events reported in the studies within this review was <1%.

Conclusions: PAE is both safe and durable for patients suffering from BPH and can be effective across a wide range of baseline PVs.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Arteries / diagnostic imaging
  • Embolization, Therapeutic* / adverse effects
  • Humans
  • Lower Urinary Tract Symptoms* / therapy
  • Male
  • Prostate / blood supply
  • Prostatic Hyperplasia* / complications
  • Prostatic Hyperplasia* / diagnostic imaging
  • Prostatic Hyperplasia* / therapy
  • Quality of Life
  • Treatment Outcome
  • Vascular Surgical Procedures / adverse effects