Prostate Artery Embolization backed by the Society of Interventional Radiology (SIR) as Safe, Effective.

In Uncategorized by VIVA

Virginia Interventional and Vascular Associates’ Board Certified Radiologist, Fellowship Trained in Interventional Radiology, Dr. Gustavo Elias, conducted the very first Prostate Artery Embolization (PAE) procedure in the Fredericksburg Region in August 2018. In collaboration with Mary Washington Healthcare, Virginia Interventional and Vascular Associates (VIVA) is proud to provide PAE, the latest minimally invasive treatment for patients with benign prostatic hyperplasia (BPH). PAE procedures are backed by the Society of Interventional Radiology as published in its positioning statement last month.

“I felt very compelled to bring this procedure to the area,” said Dr. Elias. “Since one-third of all men aged 40-80 develop an enlarged prostate, PAE offers a new, minimally invasive treatment for improving the symptoms of BPH without the higher risk of complications that can be associated with surgery.” 

Dr. Elias trained at Yale-New Haven Hospital under the tutelage of Dr. Raj Ayyagari. During his time there, Yale-New Haven performed the largest number of PAE procedures in New England. Dr. Elias now brings this world-renowned expertise to the local region. 

The effect of BPH on patients’ lives is staggering. Dr. Elias stated, “the symptoms of BPH, including frequent or urgent need to urinate, inability to empty the bladder, and frequent urination at night, have caused hours of lost productivity and had a negative impact on quality of life for those suffering from the condition.” 

SIR publishes positioning statement on Prostate Artery Embolization 

The Society of Interventional Radiology (SIR) has published a new multisociety positioning statement on Prostate Artery Embolization (PAE). Together with the Cardiovascular and Interventional Radiological Society of Europe, the Société Française de Radiologie, and the British Society of Interventional Radiology, SIR now recognizes PAE as a safe and effective minimally invasive treatment option for men suffering from benign prostatic hypertrophy (BPH). 

In its official position statement, SIR states: “PAE for BPH is a novel and promising therapy that appears safe and efficacious based on short-term follow-up. Patient satisfaction is high and repeat intervention rates are low.”

The position statement continues, “Interventional Radiologists, given their knowledge of arterial anatomy, experience with microcatheter techniques, and expertise in other embolization procedures, are the specialists best suited for the performance of PAE.” 

With ever-expanding advancements in interventional therapy, “SIR supports the performance of high-quality clinical research to expand the numbers of patients studied, to extend the duration of follow-up, and to compare the PAE procedure against existing surgical therapies.”*

What is Prostate Artery Embolization? 

Prostate artery embolization (PAE) is a minimally invasive procedure for the treatment of benign prostatic hypertrophy, commonly referred to as BPH. The procedure is performed as an alternative to transurethral resection of the prostate (TURP). TURP is the current surgical standard of treatment but is also associated with a higher risk of complications such as incontinence, bleeding, retrograde ejaculation into the bladder, and hospitalization. 

The outpatient, minimally invasive PAE procedure shrinks the prostate by treating the blood vessels leading to the organ. Through a pinhole incision in either the wrist or upper thigh, tiny microscopic beads are injected under x-ray guidance into the right and left prostatic arteries. By obstructing the prostatic arteries and blocking the blood flow, the result is gland ischemia and a subsequent reduction of the size of the prostate. The procedure aims to alleviate the symptoms of BPH, including a weak urine stream, frequent trips to the bathroom to urinate, urinating often at night, and difficulty starting a urine stream. 

Preparation may include: 

●     Imaging study of the arteries and prostate gland

●     Evaluation of urine flow

●     Blood test

Who is a candidate for PAE?

PAE may be the ideal procedure for patients who: 

●      Are not candidates for surgical resection

●      Want to avoid general anesthesia 

●      Prefer not to have an invasive procedure

PAE is currently not recommended for patients who: 

●      Have prostate cancer 

●      Have arteries that will not accommodate the procedure 

For more information about PAE or to schedule your consultation at Virginia Interventional and Vascular Associates, please call (540) 654-9118.

* McWilliams JP, Bilhim TA, Carnevale FC, et al. Society of interventional radiology multisociety consensus position statement on prostatic artery embolization for treatment of lower urinary tract symptoms attributed to benign prostatic hyperplasia: from the society of interventional radiology, the cardiovascular and interventional radiological society of europe, société française de radiologie, and the british society of interventional radiology. Journal of Vascular and Interventional Radiology, Volume 30, Issue 5, 627 – 637.e1.