FRANCISCO CESAR CARNEVALE

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Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico

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Autor e Coautores FMUSP-HC Normalizados: MIGUEL SROUGI × Revista / Livro: Radiology ×

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  • article 50 Citação(ões) na Scopus
    Prostatic Artery Embolization for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: 10 Years' Experience
    (2020) CARNEVALE, Francisco Cesar; MOREIRA, Airton Mota; ASSIS, Andre Moreira de; ANTUNES, Alberto Azoubel; RODRIGUES, Vanessa Cristina de Paula; SROUGI, Miguel; CERRI, Giovanni Guido
    Background: Long-term experience with prostatic artery embolization (PAE) for benign prostatic hyperplasia remains limited. Purpose: To evaluate the efficacy, safety, and long-term results of PAE for benign prostatic hyperplasia. Materials and Methods: This retrospective single-center study was conducted from June 2008 to June 2018 in patients with moderate-to severe benign prostatic hyperplasia-related symptoms. International Prostate Symptom Score (IPSS), quality-of-life score, maximum urinary flow rate, postvoid residual volume, prostate-specific antigen (PSA), and prostate volume were assessed. PAE was performed with 100-500-mu m embolic microspheres. Mixed-model analysis of variance and Kaplan-Meyer method was accessed, as appropriate. Results: A total of 317 consecutive men (mean age 6 standard deviation, 65 years 6 8) were treated. Follow-up ranged from 3 months to 96 months (mean, 27 months). Bilateral and unilateral PAE was performed in 298 (94%) and 19 (6%) men, respectively. Early clinical failure occurred in six (1.9%) and symptom recurrence in 72 (23%) men at a median follow-up of 72 months. Mean maximum improvement was as follows: IPSS, 16 points +/- 7; quality-of-life score, 4 points +/- 1; prostatic volume reduction, 39 cm(3) +/- 39 (39% +/- 29); maximum urinary flow rate, 6 mL/sec +/- 10 (155% +/- 293); and postvoid residual volume, 70 mL +/- 6121 (48% +/- 81) (P < .05 for all). Unilateral PAE was associated with higher recurrence (42% vs 21%; P =.04). Baseline PSA was inversely related with recurrence (hazard ratio, 0.9 per nanograms per milliliter of PSA; 95% confidence interval [CI], 0.8, 0.9; P < .001). Embolization with combined particle sizes (100-500 mu m) did not relate to symptom recurrence (hazard ratio, 0.4; 95%CI: 0.2, 1.1 for 100-500-mu m group vs 300-500-mu m group and hazard ratio, 0.4; 95% CI: 0.1, 1.5 for 100-500-mu m group vs 100-300-mm group; P =.19). None of the patients presented with urinary incontinence or erectile dysfunction. Conclusion: Prostatic artery embolization was a safe and effective procedure for benign prostatic hyperplasia with good long-term results for lower urinary tract symptoms. (C) RSNA, 2020