title: Role of Coil Embolization during Prostatic Artery Embolization: Incidence, Indications, and Safety Profile☆.
abstract: OBJECTIVE
  To determine if coil embolization is a safe adjunctive measure to prevent nontarget embolization during prostatic artery embolization (PAE).
  
  
  METHODS
  A retrospective analysis of patients who underwent PAE with coil embolization (cPAE) or without coil embolization (nPAE) between January 2014 and June 2016 was conducted. Adverse events, identified in accordance with SIR guidelines, and procedural variables were compared between the 2 cohorts.
  
  
  RESULTS
  Of 122 patients, 32 (26.2%) underwent coil embolization in 39 arteries, with coils placed to prevent nontarget embolization (n = 36), treat prostatic artery extravasation (n = 2), and occlude an intraprostatic arteriovenous fistula (n = 1). Compared with nPAE, cPAE had a nonsignificant increase in dose area product (64,516 μGy·m2vs 52,100 μGy·m2, P = .053) but significantly longer procedure (160.1 min vs 137.1 min, P = .022) and fluoroscopy (62.9 min vs 46.1 min, P = .023) times. One major complication (urosepsis) occurred in each group (cPAE, 1/32 [3.1%]; nPAE, 1/80 [1.3%]). Both cases resolved after 2 weeks of intravenous antibiotics. A minor ischemic complication (1/32 [3.1%]) occurred in a patient with coil embolization, which manifested as white discoloration of the glans penis and resolved with topical therapy. There were no statistically significant differences in major and minor complications between cohorts at 1-month and 3-month follow-up visits.
  
  
  CONCLUSIONS
  Although coil embolization leads to increases in procedure and fluoroscopy times, it is a safe adjunctive technique to occlude communications between the prostatic artery and pelvic vasculature to potentially prevent nontarget embolization.
authors.affiliation: Department of Vascular and Interventional Radiology, (R-109) PO Box 016960,Miami, FL 33101. Electronic address: Sbhatia1@med.miami.edu.
authors.forename: Shivank
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: University of Miami Miller School of Medicine, Jackson Memorial Hospital, (R-109) PO Box 016960,Miami, FL 33101.
authors.forename: Vishal
authors.initials: V
authors.lastname: Sinha
authors.affiliation: Department of Vascular and Interventional Radiology, (R-109) PO Box 016960,Miami, FL 33101.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bordegaray
authors.affiliation: Department of Vascular and Interventional Radiology, (R-109) PO Box 016960,Miami, FL 33101.
authors.forename: Issam
authors.initials: I
authors.lastname: Kably
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth,Hanover, New Hampshire.
authors.forename: Sardis
authors.initials: S
authors.lastname: Harward
authors.affiliation: Department of Vascular and Interventional Radiology, (R-109) PO Box 016960,Miami, FL 33101.
authors.forename: Govindarajan
authors.initials: G
authors.lastname: Narayanan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply*; D011469:Prostatic Diseases / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome