title: [X-ray-guided endovascular surgery in patients with benign prostatic hyperplasia and prostate cancer].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of superselective embolization and chemoembolization of the prostatic artery as an independent method of treating prostate cancer and BPH.
  
  
  METHODS
  From 2004 to 2015, 116 patients with BPH (mean age 73.2+/-5.2 years) underwent prostatic artery embolization. Mean prostate volume ranged from 55 to 296 cc3. From 2011 to 2015, 37 patients with prostate cancer (mean age 72.3+/-2.06 years) were treated with X-ray-guided endovascular chemoembolization. All patients had confirmed PCa, of whom 7 had stage T2a and 30 stage T2c disease. PSA ranged from 0.8 to17 ng/ml (mean 13.1+/-3.9). Prostate volume ranged from 61 to 93 cc3 (mean 69.4+/-9.3). The follow-up ranged from 8 to 42 months.
  
  
  RESULTS
  Prostatic artery embolization in BPH patients resulted in a significant reduction in IPSS symptom score and increase in Qmax. The volume of prostate and nodular mass decreased on average by 53% and 47%, respectively, maximum by 82%. Chemoembolization was effective in 31 (83.7%) patients. An objective response was achieved in reducing the PSA level and prostate volume measured by TRUS, and improved urination. The median PSA at 6 months was - 3.4 +/- 0.02 ng/ml. In all patients, chemoembolization resulted in a marked reduction in the prostate volume. The greatest decrease in the prostate volume was observed at 6 months after treatment. Chemoembolization led to a marked improvement in the quality of urination confirmed by uroflowmetry and IPSS symptom scores. At 12 months, 16 patients with prostate cancer underwent the follow-up biopsy. In 12 cases pathology showed fibrosis and epithelial degeneration without signs of atypia and in 2 cases curative pathomorphosis was observed. Chemoembolization was well tolerated and did not cause any significant complications.
  
  
  CONCLUSIONS
  Embolization techniques for BPH and chemoembolization for localized PCa showed good effectiveness and safety in patients who had medical contraindications to traditional treatments.
authors.affiliation: Department of Specialized Surgery in Urology, Traumatology and Ophthalmology, Altai State Medical University, Barnaul, Russia.
authors.forename: A I
authors.initials: AI
authors.lastname: Neimark
authors.affiliation: Department of Urology, Clinical Hospital at Barnaul Railway Station of JSC RZD, Barnaul, Russia.
authors.forename: M A
authors.initials: MA
authors.lastname: Tachalov
authors.affiliation: Department of Specialized Surgery in Urology, Traumatology and Ophthalmology, Altai State Medical University, Barnaul, Russia.
authors.forename: B A
authors.initials: BA
authors.lastname: Neimark
authors.affiliation: Department of Specialized Surgery in Urology, Traumatology and Ophthalmology, Altai State Medical University, Barnaul, Russia.
authors.forename: D V
authors.initials: DV
authors.lastname: Torbik
authors.affiliation: Department of Diagnostic and Interventional Radiology, Altai Regional Clinical Hospital, Barnaul, Russia.
authors.forename: D D
authors.initials: DD
authors.lastname: Arzamastsev
mesh_terms: D000368:Aged; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D011467:Prostate / Q000098:blood supply; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D014965:X-Rays
keywords: benign prostatic hyperplasia; chemoembolization; prostate cancer; prostatic artery; superselective X-ray-guided endovascular embolization