Factors Predicting a Good Symptomatic Outcome After Prostate Artery Embolisation (PAE)

Cardiovasc Intervent Radiol. 2018 Aug;41(8):1152-1159. doi: 10.1007/s00270-018-1912-5. Epub 2018 Feb 26.


Introduction: As prostate artery embolisation (PAE) becomes an established treatment for benign prostatic obstruction, factors predicting good symptomatic outcome remain unclear. Pre-embolisation prostate size as a predictor is controversial with a handful of papers coming to conflicting conclusions. We aimed to investigate if an association existed in our patient cohort between prostate size and clinical benefit, in addition to evaluating percentage volume reduction as a predictor of symptomatic outcome following PAE.

Materials or methods: Prospective follow-up of 86 PAE patients at a single institution between June 2012 and January 2016 was conducted (mean age 64.9 years, range 54-80 years). Multiple linear regression analysis was performed to assess strength of association between clinical improvement (change in IPSS) and other variables, of any statistical correlation, through Pearson's bivariate analysis.

Results: No major procedural complications were identified and clinical success was achieved in 72.1% (n = 62) at 12 months. Initial prostate size and percentage reduction were found to have a significant association with clinical improvement. Multiple linear regression analysis (r2 = 0.48) demonstrated that percentage volume reduction at 3 months (r = 0.68, p < 0.001) had the strongest correlation with good symptomatic improvement at 12 months after adjusting for confounding factors.

Conclusion: Both the initial prostate size and percentage volume reduction at 3 months predict good symptomatic outcome at 12 months. These findings therefore aid patient selection and counselling to achieve optimal outcomes for men undergoing prostate artery embolisation.

Keywords: BPH; Embolization; Outcome; PAE; Predictor; Prostate.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction / methods
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / therapy*
  • Computed Tomography Angiography / methods
  • Embolization, Therapeutic / methods*
  • Humans
  • Male
  • Middle Aged
  • Organ Size
  • Prospective Studies
  • Prostate / blood supply*
  • Prostate / diagnostic imaging
  • Prostate / pathology
  • Prostatic Diseases / diagnostic imaging
  • Prostatic Diseases / therapy*
  • Treatment Outcome