Prostatic artery embolization for benign prostatic hyperplasia: State of the art

Camille Cherrak; Xavier Guerra; Julien Panneau; Vincent Vidal; Jafar Golzarian; Charles Dariane; Marc Sapoval; Tom Boeken

doi:10.1016/j.diii.2026.03.002

Prostatic artery embolization for benign prostatic hyperplasia: State of the art

Diagn Interv Imaging. 2026 Mar 21:S2211-5684(26)00050-1. doi: 10.1016/j.diii.2026.03.002. Online ahead of print.

Authors

Camille Cherrak¹, Xavier Guerra², Julien Panneau³, Vincent Vidal³, Jafar Golzarian⁴, Charles Dariane⁵, Marc Sapoval², Tom Boeken²

Affiliations

¹ Department of Vascular & Oncological Interventional Radiology, Hôpital Européen Georges Pompidou, APHP, 70015, Paris, France; Université Paris Cité, Faculté de Médecine, HeKA, INRIA, Paris, 75006, Paris, France. Electronic address: camille.cherrak@aphp.fr.
² Department of Vascular & Oncological Interventional Radiology, Hôpital Européen Georges Pompidou, APHP, 70015, Paris, France; Université Paris Cité, Faculté de Médecine, HeKA, INRIA, Paris, 75006, Paris, France.
³ Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, 13005, Marseille, France- Aix Marseille Université, LIIE, CERIMED, 13385, Marseille, France.
⁴ Department of Radiology, University of Minnesota, Minneapolis, Minnesota, 55455, USA.
⁵ Department of Urology and Transplant Surgery, Hôpital Européen Georges-Pompidou, AP-HP, Université Paris Cité, 75006, Paris, France.

PMID: 41866253
DOI: 10.1016/j.diii.2026.03.002

Abstract

Over the past 25 years, prostatic artery embolization has emerged as a minimally invasive, organ-sparing alternative for managing benign prostatic hyperplasia. Though once considered experimental, it is now endorsed by major international radiological and urological societies as a valid therapeutic option for select patients. Its clinical efficacy has been proven, demonstrating durable improvement in lower urinary tract symptoms and quality of life. In the last five years, significant progress has been made in patient selection, imaging guidance, and embolic materials. This includes the introduction of liquid embolic agents, which are a promising innovation, but are still the subject of controversy and lack long-term outcome data. Meanwhile, artificial intelligence is emerging as a promising tool to support patient selection, procedural planning, and intraoperative guidance. However, its clinical implementation is still in its early stages. This review offers a thorough synthesis of the latest evidence and ongoing developments in prostatic artery embolization. It highlights significant progress and ongoing controversies, pinpoints knowledge gaps, and discusses their implications for clinical practice and future research.

Keywords: Benign prostatic hyperplasia; Interventional radiology; Prostatic artery embolization; Quality of life; Treatment outcomes.

Publication types

Review