Abstract
Prostate artery embolization (PAE) is a technically demanding new treatment option for benign prostatic hyperplasia. We present a case of radiation-induced dermitis in a 63-year-old patient after a technically successful PAE, due to high radiation exposure (KAP: 8,023,949 mGy cm2) and long fluoroscopy time (72 min). Anatomical and technical aspects are discussed, as well as recommendations to decrease radiation exposure in these procedures.
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Antunes AA, Carnevale FC, da Motta-Leal-Filho JM, Yoshinaga EM, Cerri LM, Baroni RH et al (2013) Clinical, laboratorial and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study. Cardiovasc Intervent Radiol 36:978–986 Epub 2013 Apr 12
Bagla S, Martin CP, van Breda A, Sheridan MJ, Sterling KM, Papadouris D et al (2014) Early results from a United States trial of prostatic artery embolization in the treatment of benign prostatic hyperplasia. J Vasc Interv Radiol. 25:47–52 Epub 2014 Jun 30
Pisco JM, Rio Tinto H, Campos Pinheiro L, Bilhim T, Duarte M et al (2013) Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol 23:2561–2572 Epub 2013 Jan 31. Erratum in: Eur Radiol 2013; 23(9):2573–2574
Bilhim T, Pisco J, Campos Pinheiro L, Rio Tinto H, Fernandes L, Pereira JA, Duarte M, Oliveira AG (2013) Does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study. J Vasc Interv Radiol 24:1595–1602.e1 Epub 2013 Aug 3
Carnevale FC, Antunes AA (2013) Prostatic artery embolization for enlarged prostates due to benign prostatic hyperplasia. How I do it. Cardiovasc Intervent Radiol 36(6):1452–1463 Epub 2013 Aug 1
McWilliams JP, Kuo MD, Rose SC, Bagla S, Caplin DM, Cohen EI, Faintuch S, Spies JB, Saad WE, Nikolic B (2014) Society of interventional radiology position statement: prostate artery embolization for treatment of benign disease of the prostate. J Vasc Interv Radiol 25(9):1349–1351 Epub 2014 Jun 30
Carnevale FC, Moreira AM, Antunes AA (2014) The “PErFecTED technique”: proximal embolization first, then embolize distal for benign prostatic hyperplasia. Cardiovasc Intervent Radiol 37(6):1602–1605 Epub 2014 Jun 19
Bilhim T, Casal D, Furtado A, Pais D, O’neill JEG, Pisco JM (2011) Branching patterns of the male internal iliac artery: imaging findings. Surg Radiol Anat 33(2):151–159 Epub 2010 Aug 27
Assis AM, Rodrigues VCP, Yoshinaga EM, Antunes AA, Harward SH, Srougi M, et al. (2014) Prostatic artery embolization (PAE) for treatment of benign prostatic hyperplasia in patients with prostates exceeding 90 g: a prospective single center study. J Vasc Interv Radiol. doi:10.1016/j.jvir.2014.10.012 (in press)
Nikolic B, Spies JB, Lundsten MJ, Abbara S (2000) Patient radiation dose associated with uterine artery embolization. Radiology 214:121–125 Erratum in: Radiology 2001; 218(3): 920
Kirkwood ML, Arbique GM, Guild JB, Timaran C, Valentine RJ, Anderson JA (2014) Radiation-induced skin injury after complex endovascular procedures. J Vasc Surg 60(3):742–748 Epub 2014 Apr 24
Balter S, Miller DL (2014) Patient skin reactions from interventional fluoroscopy procedures. AJR Am J Roentgenol 202:W335–W342
Valentin J (2000) Avoidance of radiation injuries from medical interventional procedures. Ann ICRP 30(2):7–67
Hirshfeld JW Jr, Balter S, Brinker JA, Kern MJ, Klein LW, Lindsay BD, Tommaso CL, Tracy CM, Wagner LK, Creager MA, Elnicki M, Lorell BH, Rodgers GP, Weitz HH, American College of Cardiology Foundation, American Heart Association/, HRS, SCAI, American College of Physicians Task Force on Clinical Competence and Training (2005) ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. Circulation 111(4):511–532
Stecker, Balter S, Towbin RB, Miller DL, Vañó E, Bartal G, Angle JF, Chao CP, Cohen AM, Dixon RG, Gross K, Hartnell GG, Schueler B, Statler JD, de Baère T, Cardella JF, SIR Safety and Health Committee, CIRSE Standards of Practice Committee (2009) Guidelines for patient radiation dose management. J Vasc Interv Radiol 20:S263–S273
Bartal G, Vano E, Paulo G, Miller DL (2014) Management of patient and staff radiation dose in interventional radiology: Current concepts. Cardiovasc Intervent Radiol 37:289–298 Epub 2013 Jul 16
Acknowledgments
We thank Pedro Ruiz Manzano, from the Radioprotection Service of Lozano Blesa University Hospital, for his valuable help in this work, and the Urology Service of Lozano Blesa University Hospital, for their collaboration with our Department.
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Alicia Laborda, Andre Moreira De Assis, Ignatios Ioakeim, María Sánchez-Ballestín, Francisco Cesar Carnevale, and Miguel Angel De Gregorio declare that they have no conflicts of interest or financial disclosures.
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Laborda, A., De Assis, A.M., Ioakeim, I. et al. Radiodermitis After Prostatic Artery Embolization: Case Report and Review of the Literature. Cardiovasc Intervent Radiol 38, 755–759 (2015). https://doi.org/10.1007/s00270-015-1083-6
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DOI: https://doi.org/10.1007/s00270-015-1083-6