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Prostatic Artery Embolization for Benign Prostatic Obstruction: Single-Centre Retrospective Study Comparing Microspheres Versus n-Butyl Cyanoacrylate

  • Clinical Investigation
  • Embolisation (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the safety and efficacy of n-butyl cyanoacrylate glue (NBCA) versus microspheres for prostatic artery embolization (PAE) in patients with benign prostatic obstruction (BPO).

Materials and Methods

This institutional review board-approved, single-centre, retrospective study included consecutive patients undergoing PAE from September 2017 to July 2020. Age, medical history, previous treatment, pre- and post-PAE prostatic volumes and International Prostate Symptom Scores (IPSSs) were systematically analysed. Procedural duration, dosimetry, immediate and delayed complications were recorded. Patients at the beginning of the study were treated with microspheres and patients at the end of the study with NBCA. The main outcome measures were the absolute and relative changes in IPSS at 3 months. Statistical analyses comprised unpaired t-tests, Wilcoxon tests, Chi-2 tests, uni- and multivariate linear regressions.

Results

Sixty-two patients were included (median age: 65.9 years). Thirty-two patients were treated with microspheres and 30 with NBCA. There were no significant baseline differences between the two groups except for the baseline PSA (P = 0.0251). Average procedural and fluoroscopy times, and radiation exposure were significantly lower in the NBCA group versus the microspheres group (80.7 ± 22.5 versus 112 ± 42.1 min [P = 0.0011], 24.2 ± 9.6 min versus 42.1 ± 20.2 min [P = 0.0001], 12,004.6 ± 6702 uGy.m2 versus 25,614.9 ± 15,749.2 uGy.m2 [P = 0.0001], respectively). Immediate complications were all minor, and there were no significant differences between the two groups (4/32 [12.5%] with microspheres versus 7/30 [23.3%] with NBCA, P = 0.4335), nor for delayed complications (P = 1). No association was found between the PAE techniques and the absolute change in IPSS at 3 months (−10.2 ± 7.9 with microspheres versus −9.5 ± 7.6 with NBCA, P = 0.7157).

Conclusion

PAE using NBCA was safe and effective for symptomatic BPO, with faster procedures, lower radiation exposure and similar safety and efficacy compared to microspheres. Operator learning curve could have biased the procedural times and radiation exposure between groups favouring NBCA.

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Abbreviations

BPH:

Benign prostatic hyperplasia

BPO:

Benign prostatic obstruction

IIA:

Internal iliac artery

IIEF:

International Index of Erectile Function

IPSS:

International Prostate Symptoms Score

KAP:

Kerma area product

LUTS:

Lower urinary tract symptoms

NBCA:

n-Butyl cyanoacrylate

PAE:

Prostatic artery embolization

PSA:

Prostatic-specific antigen

QOL:

Quality of life

rCFA:

Right common femoral artery

TURP:

Transurethral resection of the prostate

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Interventional Radiology, Hopital Pellegrin, Universitaire de Bordeaux, 33000, Bordeaux, France

    Etienne Salet, Nicolas Grenier, Clément Marcelin, Yann Lebras, Eva Jambon, Alexis Coussy & François Petitpierre

  2. Department of Oncology Imaging, Institute Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33076, Bordeaux, France

    Amandine Crombé

  3. Universitaire de Bordeaux, 33000, Bordeaux, France

    Amandine Crombé & Nicolas Grenier

  4. Department of Radiology, Tenon Hospital, Sorbonne University, Paris, France

    François H. Cornelis

  5. Centre Aquitain d’Imagerie, 33700, Mérignac, France

    François Petitpierre

Authors
  1. Etienne Salet
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  2. Amandine Crombé
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  3. Nicolas Grenier
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  4. Clément Marcelin
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Correspondence to François Petitpierre.

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This study has obtained IRB approval from Pellegrin University Hospital, and the need for informed consent was waived.

Ethical Approval

This retrospective study was approved by the Institutional Review Board of Pellegrin University Hospital, Bordeaux, France.

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The need for written informed consent was waived by its retrospective nature.

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Salet, E., Crombé, A., Grenier, N. et al. Prostatic Artery Embolization for Benign Prostatic Obstruction: Single-Centre Retrospective Study Comparing Microspheres Versus n-Butyl Cyanoacrylate. Cardiovasc Intervent Radiol 45, 814–823 (2022). https://doi.org/10.1007/s00270-022-03069-3

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  • DOI: https://doi.org/10.1007/s00270-022-03069-3

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