ALBERTO AZOUBEL ANTUNES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
5 resultados
Resultados de Busca
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- Prostatic Tissue Elimination After Prostatic Artery Embolization (PAE): A Report of Three Cases(2017) LEITE, Leandro Cardarelli; ASSIS, Andre Moreira de; MOREIRA, Airton Mota; HARWARD, Sardis Honoria; ANTUNES, Alberto Azoubel; CARNEVALE, Francisco CesarWe report three cases of spontaneous prostatic tissue elimination through the urethra while voiding following technically successful prostatic artery embolization (PAE) as a treatment for lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). All patients were embolized with 100- to 300-mu m microspheres alone or in combination with 300- to 500-mu m microspheres. During follow-up prior to eliminating the tissue fragments, the three patients all presented with intermittent periods of LUTS improvement and aggravation. After expelling the prostatic tissue between 1 and 5 months of follow-up, significant improvements in LUTS and urodynamic parameters were observed in all patients. Urethral obstruction after PAE caused by sloughing prostate tissue is a potential complication of the procedure and should be considered in patients with recurrent LUTS in order to avoid inappropriate management.
- Prostatic Artery Embolization to Treat Lower Urinary Tract Symptoms Related to Benign Prostatic Hyperplasia and Bleeding in Patients with Prostate Cancer: Proceedings from a Multidisciplinary Research Consensus Panel(2014) GOLZARIAN, Jafar; ANTUNES, Alberto A.; BILHIM, Tiago; CARNEVALE, Francisco Cesar; KONETY, Badrinath; MCVARY, Kevin T.; PARSONS, J. Kellogg; PISCO, Joao-Martins; SIEGEL, David N.; SPIES, James; WASSERMAN, Neil; GOWDA, Naveen; AHRAR, Kamran
- Prostatic Artery Embolization for Treatment of Benign Prostatic Hyperplasia in Patients with Prostates > 90 g: A Prospective Single-Center Study(2015) ASSIS, Andre Moreira de; MOREIRA, Airton Mota; RODRIGUES, Vanessa Cristina de Paula; YOSHINAGA, Eduardo Muracca; ANTUNES, Alberto Azoubel; HARWARD, Sardis Honoria; SROUGI, Miguel; CARNEVALE, Francisco CesarPurpose: To describe the safety and efficacy of prostatic artery embolization (PAE) with spherical microparticles to treat lower urinary tract symptoms associated with benign prostatic hyperplasia in patients with prostate volume > 90 g. Materials and Methods: This prospective, single-center, single-arm study was conducted in 35 patients with prostate volumes ranging from 90-252 g. Mean patient age was 64.8 years (range, 53-77 y). Magnetic resonance imaging, uroflowmetry, and the International Prostate Symptom Score (IPSS) were used to assess clinical and functional outcomes. Results: Mean prostate size decreased significantly from 135.1 g before PAE to 91.9 g at 3 months of follow-up (P < .0001). Mean IPSS and quality-of-life index improved from 18.3 to 2.7 and 4.8 to 0.9 (P < .0001 for both), respectively. A significant negative conelation was observed between prostate-specific antigen at 24 hours after PAE and IPSS 3 months after PAE (P = .0057). Conclusions: PAE is a safe and effective treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia in patients with prostate volume > 90 g. Excessively elevated prostate-specific antigen within 24 hours of PAE is associated with; lower symptom burden in short-term follow-up.
- Recurrence of Lower Urinary Tract Symptoms Following Prostate Artery Embolization for Benign Hyperplasia: Single Center Experience Comparing Two Techniques(2017) CARNEVALE, Francisco Cesar; MOREIRA, Airton Mota; HARWARD, Sardis Honoria; BHATIA, Shivank; ASSIS, Andre Moreira de; SROUGI, Miguel; CERRI, Giovanni Guido; ANTUNES, Alberto AzoubelTo compare recurrence of lower urinary tract symptoms (LUTS) recurrence at 12 months following original prostate artery embolization (oPAE) or ""proximal embolization first, then embolize distal"" (PErFecTED) PAE for benign prostatic hyperplasia (BPH). 105 consecutive patients older than 45 years, with prostate size greater than 30 cm(3), International Prostate Symptom Score (IPSS) ae 8, quality of life (QoL) index ae 3, and refractory status or intolerance of medical management were prospectively enrolled between June 2008 and August 2013. The study was IRB-approved, and all patients provided informed consent. Patients underwent oPAE or PErFecTED PAE and were followed for at least 12 months. Technical success was defined as bilateral embolization and clinical success (non-recurrence) was defined as removal of the Foley catheter in patients with urinary retention, IPSS < 8 and QoL index < 3 at 12 months of follow-up. Nonparametric statistics were used to compare the study groups due to the size of the study population and distributions of clinical data. 97 patients had 12-month data and were categorized as oPAE without recurrence (n = 46), oPAE with recurrence (n = 13), PErFecTED without recurrence (n = 36), or PErFecTED with recurrence (n = 2). Recurrence was significantly more common in oPAE patients (chi (2), p = 0.026). Unilateral embolization was significantly associated with recurrence among patients who underwent oPAE (chi (2), p = 0.032). Both oPAE and PErFecTED PAE are safe and effective methods for treatment of LUTS, but PErFecTED PAE is associated with a significantly lower rate of symptom recurrence.
- Pelvic Arterial Anatomy Relevant to Prostatic Artery Embolisation and Proposal for Angiographic Classification(2015) ASSIS, Andre Moreira de; MOREIRA, Airton Mota; RODRIGUES, Vanessa Cristina de Paula; HARWARD, Sardis Honoria; ANTUNES, Alberto Azoubel; SROUGI, Miguel; CARNEVALE, Francisco CesarTo describe and categorize the angiographic findings regarding prostatic vascularization, propose an anatomic classification, and discuss its implications for the PAE procedure. Angiographic findings from 143 PAE procedures were reviewed retrospectively, and the origin of the inferior vesical artery (IVA) was classified into five subtypes as follows: type I: IVA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery (SVA); type II: IVA originating from the anterior division of the IIA, inferior to the SVA origin; type III: IVA originating from the obturator artery; type IV: IVA originating from the internal pudendal artery; and type V: less common origins of the IVA. Incidences were calculated by percentage. Two hundred eighty-six pelvic sides (n = 286) were analyzed, and 267 (93.3 %) were classified into I-IV types. Among them, the most common origin was type IV (n = 89, 31.1 %), followed by type I (n = 82, 28.7 %), type III (n = 54, 18.9 %), and type II (n = 42, 14.7 %). Type V anatomy was seen in 16 cases (5.6 %). Double vascularization, defined as two independent prostatic branches in one pelvic side, was seen in 23 cases (8.0 %). Despite the large number of possible anatomical variations of male pelvis, four main patterns corresponded to almost 95 % of the cases. Evaluation of anatomy in a systematic fashion, following a standard classification, will make PAE a faster, safer, and more effective procedure.