The “PErFecTED Technique”: Proximal Embolization First, Then Embolize Distal for Benign Prostatic Hyperplasia

Prostatic artery embolization requires a refined technique to achieve good imaging and clinical success. The PErFecTED (Proximal Embolization First, Then Embolize Distal) technique has produced greater prostate ischemia and infarction than previously described methods with clinical improvement of lo...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2014-12, Vol.37 (6), p.1602-1605
Main Authors: Carnevale, Francisco C., Moreira, Airton Mota, Antunes, Alberto A.
Format: Article
Language:English
Subjects:
Angiography, Digital Subtraction
Cardiology
Contrast Media - administration & dosage
Embolization, Therapeutic - methods
Humans
Imaging
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Nuclear Medicine
Prostate - blood supply
Prostatic Hyperplasia - diagnosis
Prostatic Hyperplasia - therapy
Radiology
Technical Note
Treatment Outcome
Ultrasound
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Summary:Prostatic artery embolization requires a refined technique to achieve good imaging and clinical success. The PErFecTED (Proximal Embolization First, Then Embolize Distal) technique has produced greater prostate ischemia and infarction than previously described methods with clinical improvement of lower urinary symptoms and lower recurrence rates. The microcatheter should cross any collateral branch to the bladder, rectum, corpus cavernosum, gonad, or penis and be placed distally into the prostatic artery before its branching to the central gland and peripheral zone. This technique allows better distribution of embolic material in the intraprostatic arteries and reduces risk of spasm or thrombus. Because benign prostatic hyperplasia develops primarily in the periurethral region of the prostate, the urethral group of arteries should be embolized first. Subsequent distal investigation and embolization completes occlusion and stasis of blood flow to the prostatic parenchyma. Since we added the second step to the PErFecTED technique, we have observed infarcts in all patients submitted to prostatic artery embolization.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-014-0908-z