AIRTON MOTA MOREIRA

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Lattes
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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • article 15 Citação(ões) na Scopus
    Effects of Prostatic Artery Embolization on the Dynamic Component of Benign Prostate Hyperplasia as Assessed by Ultrasound Elastography: A Pilot Series
    (2019) ASSIS, Andre Moreira de; MOREIRA, Airton Mota; CARNEVALE, Francisco Cesar; MARCELINO, Antonio Sergio Zafred; CERRI, Luciana Mendes de Oliveira; ANTUNES, Alberto Azoubel; SROUGI, Miguel; CERRI, Giovanni Guido
    PurposeTo determine the effects of prostatic artery embolization (PAE) on prostaticelasticity as assessed by Ultrasound Elastography (US-E), as well as to describe the feasibility and role of US-E as a novel tool in both pre- and post-PAE evaluation.Materials and MethodsThis is a prospective, single-center investigation that included eight patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline and 3-month follow-up evaluations were performed and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. US-E with measurement of the prostatic Elastic Modulus (EM) was performed before PAE and at 1-month follow-up.ResultsAfter PAE, US-E showed a significant reduction of prostatic EM as assessed in kPa (33.14 vs. 47.24, -29.8%, p=0.002) and in m/s (3.75 vs. 4.63, -19.0%, p<0.001). Also, the transitional/peripheral zone ratio was significantly reduced by 45.36% (0.53 vs. 0.97, p<0.05). All eight patients presented with significant LUTS improvement after PAE (p<0.05 for IPSS, QoL, prostate volume, peak urinary flow rate and PSA).ConclusionsFindings described in this study suggest that PAE significantly reduces prostaticEM, leading to a positive effect on BPH dynamic component related to prostatic elasticity. Also, it features US-E as an additional tool for pre- and post-PAE evaluation, describing a novel indication for this technology.
  • article 12 Citação(ões) na Scopus
    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 Cesar
    We 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.
  • article 8 Citação(ões) na Scopus
    Impact of 5-Alpha-Reductase Inhibitors Use at the Time of Prostatic Artery Embolization for Treatment of Benign Prostatic Obstruction
    (2019) CARDARELLI-LEITE, Leandro; ASSIS, Andre M. de; MOREIRA, Airton M.; ANTUNES, Alberto A.; CERRI, Giovanni G.; SROUGI, Miguel; CARNEVALE, Francisco C.
    Purpose: To compare the 12-month post-prostatic artery embolization (PAE) clinical outcomes of patients who were and were not taking 5-alpha-reductase inhibitors (5ARIs) at the time of PAE. Materials and Methods: A retrospective review was conducted of patients who underwent PAE from 2010 to 2017 due to lower urinary tract symptoms, secondary to benign prostatic hyperplasia (BPH). One hundred fifty-five patients were included and divided in 2 groups; these groups did not present statistically significant differences in their baseline characteristics-those taking 5ARIS (Y-5ARIs, n = 40) and those not taking 5ARIs (N-5ARIs, n = 115). International Prostate Symptom Score (IPSS), the sub-item Quality of Life (QoL), and the incidence of clinical failure were used as primary endpoints. Secondary endpoints included mean prostate volume reduction and mean peak flow rate (Q(max)) improvement. Clinical failure or recurrence was defined as absence of symptomatic improvement (IPSS >= 8 or QoL >= 3) or the need for invasive BPH treatment (PAE or transurethral resection of the prostate) during the 12-month follow-up period. Results: After 12-month follow-up, IPSS, QoL, and prostatic volume were significantly lower compared to baseline in both groups, and Q(max) showed a significant increase. No statistically significant differences were observed in outcomes between N-5ARIs and Y-5ARIs, and the clinical failure rate for both groups was approximately 20%. Conclusions: The use of 5ARIs did not show a detrimental effect on clinical outcomes of PAE, in either subjective (IPSS, QoL, and clinical failure) or objective (prostatic volume and Q(max)) parameters.
  • article 12 Citação(ões) na Scopus
    Prostatic Artery Embolization: Indications, Preparation, Techniques, Imaging Evaluation, Reporting, and Complications
    (2021) JR, Ubenicio Silveira Dias; MOURA, Mauricio Ruettimann Liberato de; VIANA, Publio Cesar Cavalcante; ASSIS, Andre Moreira de; MARCELINO, Antonio Sergio Zanfred; MOREIRA, Airton Mota; LEITE, Claudia Costa; CERRI, Giovanni Guido; CARNEVALE, Francisco Cesar; HORVAT, Natally
    Benign prostatic hyperplasia (BPH) is a noncancerous growth of the transitional zone of the prostate, which surrounds the prostatic urethra. Consequently, it can cause lower urinary tract symptoms (LUTS) and bladder outlet obstruction symptoms that may substantially reduce a patient's quality of life. Several treatments are available for BPH, including medications such as alpha-blockers and 5 alpha-reductase inhibitors and surgical options including transurethral resection of the prostate and prostatectomy. Recently, prostatic artery embolization (PAE) has emerged as a minimally invasive treatment option for selected men with BPH and moderate to severe LUTS. Adequate pre- and postprocedural evaluations with clinical examinations and questionnaires, laboratory tests, and urodynamic and imaging examinations (particularly US, MRI, and CT) are of key importance to achieve successful treatment. Considering that the use of PAE has been increasing in tertiary hospital facilities, radiologists and interventional radiologists should be aware of the main technical concepts of PAE and the key features to address in imaging reports in pre- and postprocedural settings. An invited commentary by Lopera is available online. Online supplemental material is available for this article. (C) RSNA, 2021
  • article 0 Citação(ões) na Scopus
    Prostatic Artery Embolization Using Polyethylene Glycol Microspheres: A 1-Year Follow-up Prospective Study Including 30 Patients
    (2023) PILAN, Bruna Ferreira; ASSIS, Andre Moreira de; MOREIRA, Airton Mota; RODRIGUES, Vanessa Cristina de Paula; ROCHA, Arthur Diego Dias; CARNEVALE, Francisco Cesar
    Purpose: To evaluate safety and effectiveness of prostatic artery embolization (PAE) using polyethylene glycol (PEG) microspheres in patients with moderate-to-severe benign prostatic hyperplasia (BPH).Materials and methods: A single-center, prospective study of 30 patients who underwent PAE from August 2020 to December 2021 using PEG 400-mu m microspheres was conducted. Patient evaluation data using International Prostate Symptom Score (IPSS), quality of life (QoL) score, prostate-specific antigen (PSA), peak urinary flow rate (Qmax), postvoid residual volume (PVR), and prostate volume (PV) at baseline and 3 and 12 months after PAE were obtained.Results: Bilateral PAE was performed in all patients. One patient had early clinical failure (3.3%) and another presented with lower urinary tract symptoms (LUTSs) recurrence (3.3%) at the 12-month follow-up. Twenty-eight patients (93.3%) experienced significant and durable LUTS improvement. Mean absolute (and relative) improvement at 3 and 12 months were: IPSS, 14.6 points (-69%) for both; QoL, 3.3 points (-70%) and 3.5 points (-74%); Qmax, 6.3 mL/s (+78%) and 8.6 mL/s (+100%); PSA reduction, 1.2 ng/mL (-22%) and 1.0 ng/mL (-15%); PVR reduction, 48 mL (-56%) and 58.2 mL (-49%); PV reduction, 23.4 cm(3) (-29%) and 19.6cm(3) (-25%); (P < .05 for all). No major adverse events were observed. Minor adverse events included urinary tract infection (4/30, 13.3%), prostatic tissue elimination (3/30, 10%), penile punctiform ulcer (1/30, 3.3%), and urinary retention (1/30, 3.3%).Conclusions: PAE using PEG microspheres was observed to be effective with sustained LUTS improvement at the 12-month follow-up. The incidence of urinary infection and prostatic tissue elimination was higher than previously reported for other embolics.
  • article 9 Citação(ões) na Scopus
    Intravesical Prostatic Protrusion Does Not Influence the Efficacy of Prostatic Artery Embolization
    (2021) MEIRA, Marcio; ASSIS, Andre M. de; MOREIRA, Airton M.; ANTUNES, Alberto A.; CARNEVALE, Francisco C.; SROUGI, Miguel
    Purpose: To compare the outcomes of prostatic artery embolization (PAE) in patients with different intravesical prostatic protrusion (IPP) grades. Materials and Methods: This retrospective single-center study included 128 patients (aged 50-86 years) who underwent PAE from 2013 to 2017. IPP grades were classified as follows: grade 1 (<10 mm), grade II (10-19 mm), and grade III (>= 20 min). Nineteen patients (14.8%) had grade I [mean [PP 7.8 mm, prostatic volume (PV) 64.1 cm(3)], 77 (60.2%) had grade II (mean IPP 14.9 win, PV 87.0 cm(3)), and 32 (25%) had grade III (mean IPP 26.2 mm, PV 132.6 cm(3)), P < .01. The outcomes, including PV, international prostate symptom score (1PSS), and quality of life (QoL), were compared between the IPP grades at the 12-month follow-up. Clinical failure was defined as IPSS >7 or QoL >2. Results: IPP decreased (I: -8.2%, II: -27.3%, and III: -38.7%, P = .01), and all other endpoints improved (P < .01). Adjusted covariance analysis, considering baseline PV as a confounding factor, showed no correlation between the 12-month outcomes and baseline IPP. Clinical failure was observed in 17/128 patients (13.3%) and was similar in prevalence among the IPP groups (P = .20). Minor complications occurred in 43 patients (33.6%) and major in 3 (2.3%). There were statistical differences in the complications between IPP grades II and III (P < .01). Conclusions: PAE was similarly effective in all the IPP grades at the 12-month follow-up, and there was no difference in the clinical failure between the groups. Complications in IPP Bade II were more frequent than those in IPP grade II.
  • article 39 Citação(ões) na Scopus
    Anatomical Variants in Prostate Artery Embolization: A Pictorial Essay
    (2017) CARNEVALE, Francisco Cesar; SOARES, Guilherme Rebello; ASSIS, Andre Moreira de; MOREIRA, Airton Mota; HARWARD, Sardis Honoria; CERRI, Giovanni Guido
    Prostate artery embolization (PAE) has emerged as a new treatment option for patients with symptomatic benign prostatic hyperplasia. The main challenges related to this procedure are navigating arteries with atherosclerosis and anatomical variations, and the potential risk of non-target embolization to pelvic structures due to the presence of collateral shunts and reflux of microparticles. Knowledge of classical vascular anatomy and the most common variations is essential for safe embolization, good clinical practice, and optimal outcomes. The aim of this pictorial essay is to illustrate the pelvic vascular anatomy relevant to PAE in order to provide a practical guide that includes the most common anatomical variants as well as to discuss the technical details related to each.
  • conferenceObject
    TUMOR RESPONSE EVALUATION ACCORDING TO MRECIST CRITERIA IN PATIENTS WITH HEPATOCELLULAR CARCINOMA TREATED WITH TACE-DRUG ELUTING BEADS
    (2012) CHAGAS, A. L.; KIKUCHI, L.; FREITAS, N. S.; SANTOS, A. C. B.; ALENCAR, R. S. S. M.; TANI, C. M.; MOREIRA, A. M.; ROCHA, M. S.; D'ALBUQUERQUE, L. A. C.; CARNEVALE, F. C.; CARRILHO, F. J.
    Introduction: Transarterial chemoembolization (TACE) is efficient in reduce tumoral growth and increase survival in patients with hepatocellular carcinoma (HCC). Drug eluting beads (DEB) is an embolizing device that slowly releases chemotherapy to decrease systemic toxicity during TACE. Initial studies showed that TACE-DEB is superior to conventional TACE regarding tumor response and toxicity. There is no study in our population that evaluate HCC response to TACE-DEB, according to mRECIST criteria. Objective: The aim of this study is to evaluate tumor response according to mRECIST criteria in patients with HCC treated with TACE-DEB. Methods: In the period of the study, 53 patients with HCC were treated with 65 sessions of TACE-DEB loadeD with doxorubicin 50mg. Tumor response was evaluated one month after the procedure with CT or MRI according to mRECIST criteria. Results: Median age was 62 years and 74% were male. The majority of the patients were cirrhotic (89% – CHILD A 65% and CHILD B 35%). Etilogy of liver disease was HCV in 27/53 (51%), HBV in 8/53 (15%), alcohol in 10/53 (19%) and NASH in 3/53 (6%). According to BCLC staging system, 51% was BCLC A and 49% was BCLC B. Most patients had one nodule (66%). No patient presented with extrahepatic metastasis or macroscopic vascular invasion. Tumor response according to mRECIST was possible after 60 procedures. Complete response was reached in 12/60 (20%), partial response in 31/60 (52%), stable disease in 4/60 (6.5%) and progressive disease in 13/60 (21.5%). Conclusion: In patients with compensated liver cirrhosis and HCC, TACE-DEB was efficient in induce tumor response according to mRECIST criteria, and in our study objective response (complete response + partial response) was reached in 72% os cases. Further studies are necessary to evaluate survival and predictors factors of response.
  • article 57 Citação(ões) na Scopus
    Transient Ischemic Rectitis as a Potential Complication after Prostatic Artery Embolization: Case Report and Review of the Literature
    (2013) MOREIRA, Airton Mota; MARQUES, Carlos Frederico Sparapan; ANTUNES, Alberto Azoubel; NAHAS, Caio Sergio Rizkallah; NAHAS, Sergio Carlos; ARIZA, Miguel Angel de Gregorio; CARNEVALE, Francisco Cesar
    Prostatic artery embolization (PAE) is an alternative treatment for benign prostatic hyperplasia. Complications are primarily related to non-target embolization. We report a case of ischemic rectitis in a 76-year-old man with significant lower urinary tract symptoms due to benign prostatic hyperplasia, probably related to nontarget embolization. Magnetic resonance imaging revealed an 85.5-g prostate and urodynamic studies confirmed Inferior vesical obstruction. PAE was performed bilaterally. During the first 3 days of follow-up, a small amount of blood mixed in the stool was observed. Colonoscopy identified rectal ulcers at day 4, which had then disappeared by day 16 post PAE without treatment. PAE is a safe, effective procedure with a low complication rate, but interventionalists should be aware of the risk of rectal nontarget embolization.
  • article 97 Citação(ões) na Scopus
    The ""PErFecTED Technique"": Proximal Embolization First, Then Embolize Distal for Benign Prostatic Hyperplasia
    (2014) CARNEVALE, Francisco C.; MOREIRA, Airton Mota; ANTUNES, Alberto A.
    Prostatic artery embolization requires a refined technique to achieve good imaging and clinical success. The PErFecTED (Proximal Embolization First, Then Embolize Distal) technique has produced greater prostate ischemia and infarction than previously described methods with clinical improvement of lower urinary symptoms and lower recurrence rates. The microcatheter should cross any collateral branch to the bladder, rectum, corpus cavernosum, gonad, or penis and be placed distally into the prostatic artery before its branching to the central gland and peripheral zone. This technique allows better distribution of embolic material in the intraprostatic arteries and reduces risk of spasm or thrombus. Because benign prostatic hyperplasia develops primarily in the periurethral region of the prostate, the urethral group of arteries should be embolized first. Subsequent distal investigation and embolization completes occlusion and stasis of blood flow to the prostatic parenchyma. Since we added the second step to the PErFecTED technique, we have observed infarcts in all patients submitted to prostatic artery embolization.