title: Early results from a United States trial of prostatic artery embolization in the treatment of benign prostatic hyperplasia.
abstract: OBJECTIVE
  To report early findings from a prospective United States clinical trial to evaluate the efficacy and safety of prostatic artery embolization (PAE) for benign prostatic hyperplasia (BPH).
  
  
  METHODS
  From January 2012 to March 2013, 72 patients were screened and 20 patients underwent treatment. Patients were evaluated at baseline and selected intervals (1, 3, and 6 mo) for the following efficacy variables: American Urological Association (AUA) symptom score, quality of life (QOL)-related symptoms, International Index of Erectile Function score, peak urine flow rate, and prostate volume (on magnetic resonance imaging at 6 mo). Complications were monitored and reported per Society of Interventional Radiology guidelines.
  
  
  RESULTS
  Embolization was technically successful in 18 of 20 patients (90%); bilateral PAE was successful in 18 of 19 (95%). Unsuccessful embolizations were secondary to atherosclerotic occlusion of prostatic arteries. Clinical success was seen in 95% of patients (19 of 20) at 1 month, with average AUA symptom score improvements of 10.8 points at 1 month (P < .0001), 12.1 points at 3 months (P = .0003), and 9.8 points at 6 months (P = .06). QOL improved at 1 month (1.9 points; P = .0002), 3 months (1.9 points; P = .003), and 6 months (2.6 points; P = .007). Sexual function improved by 34% at 1 month (P = .11), 5% at 3 months (P = .72), and 16% at 6 months (P = .19). Prostate volume at 6 months had decreased 18% (n = 5; P = .05). No minor or major complications were reported.
  
  
  CONCLUSIONS
  Early results from this clinical trial indicate that PAE offers a safe and efficacious treatment option for men with BPH.
authors.affiliation: Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Bagla
authors.affiliation: Grants Management Office, Inova Health System, Springfield.
authors.forename: Cynthia P
authors.initials: CP
authors.lastname: Martin
authors.affiliation: Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria.
authors.forename: Arletta
authors.initials: A
authors.lastname: van Breda
authors.affiliation: Inova Research Center, Inova Health System, Falls Church, Virginia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sheridan
authors.affiliation: Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria. Electronic address: sandeep.bagla@gmail.com.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Sterling
authors.affiliation: Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Papadouris
authors.affiliation: Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria.
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Rholl
authors.affiliation: Georgetown University School of Medicine, Washington, DC.
authors.forename: John B
authors.initials: JB
authors.lastname: Smirniotopoulos
authors.affiliation: Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria.
authors.forename: Arina
authors.initials: A
authors.lastname: van Breda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001158:Arteries; D004621:Embolization, Therapeutic / Q000009:adverse effects; D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011446:Prospective Studies; D011467:Prostate / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014481:United States
keywords: AUA; American Urological Association; BPH; IIEF; International Index of Erectile Function; PAE; QOL; TURP; benign prostatic hyperplasia; prostatic artery embolization; quality of life; transurethral resection of the prostate