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Embolization updates pages 10–13
Profile: Alban Denys page 18
September 2022 | Issue 87
“Promising” 10-year data on PAE for benign prostatic hyperplasia presented at ET
New data:
Thrombectomy for PE page 24
Treating placenta accreta spectrum with multivessel pelvic embolization
Thefindingsofacollaborative researchprojectattheUniversit California San Diego (UCSD), San Diego, USA were presented in an abstracttitled‘Multivesselpel TiagoBilhim(SaintLouisHospital,Lisbon,Portugal)presentedduringtheScientificPaper embolization during caesarean session at this year’s European Conference on Embolotherapy (ET; 22–25 June, Nice, France), hysterectomy for placenta and won the award of best abstract for his and co-authors’ ‘Long-term outcome of prostatic accreta spectrum: A single-centre artery embolization for patients with benign prostatic hyperplasia’. A key takeaway from his experience and comparison to presentationwasthatprostaticarteryembolizationPAE) ( appearsasafe “ andeäective internal treatment iliac artery balloon occlusion’ option for patients with benign prostatic hyperplasia [BPH]”. attheSocietyofInterventional Radiology (SIR) 2022 Annual ilhim et al conducted this single-centre antigen(PSA),peakurinaryflowrate(Qmax)andpostvoid Meeting (11–16 June, Boston, USA). retrospective study in 1,072 patients with followresidual (PVR) volume. Follow-up appointments took The abstract’s lead author, Christine up over a 10-year period to assess the outcomes of place yearly and also evaluated use of prostatic medication, Boone (UCSD, San Diego, USA) PAE for, as stated in the paper’s title, BPH in patients with reintervention rates and repeat PAE and prostatectomy rates. explained to Interventional News lower urinary tract symptoms (LUTS). In terms of embolic agent, Bilhim proceeded to explain her surprise at the extent of blood The authors begin the paper by outlining some of the that over the 10 years, various embolic agents were loss reduction with embolization pre-existing research in the area of PAE for BPH— data used. These were non-spherical polyvinyl alcohol (PVA) compared to internal iliac artery have shown that compared to prostatic surgery, PAE can particles, measuring 100–300 micrometres and spherical balloon occlusion (IIABO), alongside achieve “similar LUTS improvements with a lower adverse PVA microspheres, measuring 300–500 micrometres. Some othernoteworthyfindings.
B
eventprofile.”However,surgeryleadstoimprovement patients received treatment with trisacryl gelatin in all BPH objective measurements and data microspheres measuring 100–500 micrometres, THIS COLLABORATION AMONG suggest that retreatment rates for patients who or 250-400 micrometres polyzene-coated interventional radiology, obstetrics and underwent prostatic surgery may also be lower. hydrogelmicrospheres.Notably,thefirst gynaecology, and maternal foetal medicine In his presentation, Bilhim reported that group treated within the study remit received teams aimed to compare how intraoperative the study ran from March 2009–2019, and PVA particles, so their follow-up was longer. pelvic embolization performed to reduce blood the 1,072 patients who were studied excluded Mean follow-up time was 4.39±2.37 years. loss during surgical management of placenta those who did not have follow-up (11% of the Adverse events were determined accreta spectrum (PAS) versus IIABO. original study population), the 1% in whom according to Cardiovascular and Regardingthestudy’sresults,Boonefir PAE was a technical failure and the 3% who Interventional Radiology Society of Europe outlined her prediction that blood loss would were diagnosed with prostate cancer during (CIRSE) criteria, and Bilhim stated that they be“similarorbetter”amongtheemboliza follow-up. did not consider frequency, urethral burning group. “But what surprised me was by how Bilhim went on to detail how each patient sensation or slight pelvic pain lasting much[embolizationimprovedoutcomes],” was evaluated for International Prostate for one to three days post-PAE Boone went on to acknowledge. In the IIABO Symptom Score (IPSS) and quality as being in this category, but group, she noted, median blood loss was 2.5 of life (QoL), prostate volume rather as post-PAE syndrome. Tiago ai16605680847_CXAV2022 NN FP BANNER 225X55.pdf 1 15/08/2022 13:54:45 (PV)—measured with transrectal Continued on page 4 Bilhim ultrasound—prostate-specific Continued on page 2
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