Br J Radiol. 2022 Jun 28:20220243. doi: 10.1259/bjr.20220243. Online ahead of print.
ABSTRACT
OBJECTIVE: To compare the technical efficacy and safety between prostatic artery occlusion (PAO) with ethylene vinyl alcohol copolymer (EVOH) and prostatic artery embolization (PAE) with microspheres in a canine model.
METHODS: 17 adult male beagles underwent PAO (n = 7) with Onyx-18 or PAE (n = 10) with microspheres (300-500 µm). After procedures, all dogs were inspected for procedure-related complications during 1 month follow-up. MRI evaluations were performed immediately before and 1 week, 2 weeks, and 1 month after procedures to document prostate volume (PV) and the prostate ischemia size. Differences between groups were statistically analyzed.
RESULTS: Both procedures were bilaterally successful in all animals. Although the mean procedure times were comparable in both groups, the mean fluoroscopy time (23.80 vs 36.24 min, p = 0.014) and radiation dose (68.19 vs 125.26 mGy, p = 0.003) were significantly less in PAO-group. Recanalization was observed more frequently in PAE than PAO at 1 month of follow-up. The mean percentage of PV change significantly decreased at 2 weeks and 1 month in both groups (30.71% vs 37.89% at 2 week, and 56.41vs 55.56% at 1 month, after PAO and PAE respectively), without significant differences between groups at either time point. There was a significant increase in the mean prostate ischemia induced by PAO in comparison with PAE at 1 week (43.44% vs 18.91 ml, p = 0.001). No major complications were observed except one animal after PAO with transient hematuria and acute urinary retention.
CONCLUSIONS: PAO with EVOH is technically feasible and with comparable efficacy and safety with PAE.
ADVANCES IN KNOWLEDGE: A new technical modification of the prostatic artery embolization (PAE) consisting of the use of liquid embolic agent to occlude the prostatic artery trunk and its branches has been developed in preclinical study, showing to be an effective and safe procedure which can induce a significant prostate shrinkage for the management of symptomatic BPH in patients. In addition, the findings have showed a similar therapeutic effect comparable with the conventional PAE using microspheres.
PMID:35762334 | DOI:10.1259/bjr.20220243
