FRANCISCO CESAR CARNEVALE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
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- 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, MiguelPurpose: 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.
- Role of Ultrasound Elastography in Patient Selection for Prostatic Artery Embolization(2021) ASSIS, Andre Moreira de; MOREIRA, Airton Mota; CARNEVALE, Francisco Cesar; MARCELINO, Antonio Sergio Zafred; ANTUNES, Alberto Azoubel; SROUGI, Miguel; CERRI, Giovanni GuidoPurpose: To determine the effects of prostatic artery embolization (PAE) on prostate elasticity as assessed using ultrasound elastography (US-E) and to describe baseline US-E's potential role in patient selection. Materials and Methods: This was a prospective investigation that included 20 patients undergoing PAE to treat lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH). US-E with measurement of the prostatic elastic modulus (EM) and shear wave velocity (SWV) was performed before PAE and at 1-month follow-up. Baseline, 3-month, and 1-year follow-up evaluations included prostate-specific antigen, uroflowmetry, pelvic magnetic resonance imaging, and clinical assessment using the International Prostate Symptom Score (IPSS) and quality of life (QoL) metrics. Results: Seventeen patients entered statistical analysis. US-E showed a significant reduction in mean prostatic EM (34.4 kPa vs 46.3 kPa, similar to 24.7%, P <.0001) and SWV (3.55 m/s vs 4.46 m/s, similar to 20.0%, P <.0001) after PAE. There were moderate positive correlations between baseline EM and 1-year IPSS (R = 0.62, P = .007) and between baseline SWVand 1-year IPSS (R = 0.68, P = .002). Baseline SWV >= 5.59 m/s and baseline EM >= 50.14 kPa were associated with suboptimal IPSS and QoL outcomes after PAE with high degrees of sensitivity (100%) and specificity (69-100%). Conclusions: PAE led to a positive effect on the BPH dynamic component related to prostatic elasticity. There was a moderate positive correlation between baseline prostatic elastographic parameters and 12-month IPSS. Measurement of baseline elastographic characteristics may become useful for the evaluation and selection of patients for PAE.