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Objective To characterize voiding and storage symptom domain-specific outcomes after prostate artery embolization (PAE) to treat lower urinary tract symptoms (LUTS) or urinary retention caused by benign prostatic hyperplasia (BPH). Methods Two hundred forty patients (age = 74.5 ± 8.6 years) underwent PAE between May 2013 and March 2020 at a single center for LUTS (n = 161) or urinary retention (n = 79). Total International Prostate Symptom Score (IPSS-t), voiding domain score (IPSS-v), storage domain score (IPSS-s), and Quality of Life score (QoL) were obtained pre-PAE for LUTS patients (IPSS-t = 21.7 ± 6.2, IPSS-v = 11.9 ± 4.3, IPSS-s = 9.6 ± 3.1, QoL = 4.5 ± 1.2), and post-PAE through 36 months (mean = 22.9 ± 15.2 months) for LUTS and retention patients. Mean relative changes in IPSS-t, IPSS-v, IPSS-s, and QoL were calculated for LUTS patients. Mean voiding or storage component scores were calculated for retention patients. Results For evaluable LUTS patients (n = 147), IPSS-t showed sustained substantial improvement through 36 months (6.3 ± 4.2-8.6 ± 7.6), as did QoL (1.1 ± 1.1-1.8 ± 1.5). One month after PAE, improvements in IPSS-v (69% ± 29%) were greater than in IPSS-s (46% ± 33%; P Conclusions PAE effectively treated BPH-related LUTS and retention. IPSS-v improved more than IPSS-s in LUTS patients, and remained lower in LUTS and retention patients through 36 months.

Electrocardiographic abnormalities in patients with massive pulmonary embolism are common and unspecific. An 80-year-old woman was admitted to our department with severe respiratory insufficiency and hemodynamic instability. Abnormal high-sensitivity cardiac troponin I and ST-segmental elevation in II, III, aVF, and V3–V6 were present on admission. Segmental motion abnormalities of the left ventricular wall were not detectable in echocardiography. Instead, the presence of a right ventricular strain raised the suspicion of a lung artery embolization. The diagnosis was confirmed by a computed tomography of the chest, and a thrombolytic therapy with 100 mg recombinant tissue plasminogen activator (rt-PA) was administered. Though respiratory and hemodynamic stability were established, electromechanical disassociation suddenly occurred 30 hours later and the patient died. Electrocardiographic changes mimicking a myocardial infarction may occur after a massive pulmonary embolism and constitute a diagnostic challenge for clinicians being active in the field of emergency medicine and intensive care.

Over the past decade, prostate artery embolization (PAE) has emerged as a minimally invasive treatment option for patients suffering from lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Literature over that time has moved from discussion of technique and technical feasibility of the procedure to comparisons of PAE with traditional surgical therapies such as transurethral resection of the prostate (TURP). In most studies of patients undergoing PAE, transfemoral arterial access was obtained to catheterize the prostatic arteries. More recently, the use of transradial access to perform PAE has been described. While technically challenging, the transradial technique offers several potential advantages in appropriately selected patients, which may improve the benefit-risk profile of PAE and improve patient satisfaction. We describe the history and applications of PAE, list the equipment needed to perform PAE, review the procedural steps and technical considerations, and provide a case example, all in the context of transradial access.

PURPOSE: To evaluate the potential differences in non-target embolization and vessel microsphere filling of a reflux-control microcatheter (RCM) compared to a standard end-hole microcatheter (SEHM) in a swine model. MATERIALS AND METHODS: Radiopaque microspheres were injected with both RCM and SEHM (2.4-Fr and 2.7-Fr) in the kidneys of a preclinical swine model. Transarterial renal embolization procedures with RCM or SEHM were performed in both kidneys of 14 pigs. Renal arteries were selectively embolized with an automated injection protocol of radio-opaque microspheres. Ex-vivo X-ray microtomography images of the kidneys were utilized to evaluate the embolization by quantification of the deposition of injected microspheres in the target vs. the non-target area of injection. X-ray microtomography images were blindly analyzed by five interventional radiologists. The degree of vessel filling and the non-target embolization were quantified using a scale from 1 to 5 for each parameter. An analysis of variance was used to compare the paired scores. RESULTS: Total volumes of radio-opaque microspheres injected were similar for RCM (11.5±3.6 [SD] mL; range: 6-17mL) and SEHM (10.6±5.2 [SD] mL; range: 4-19mL) (P=0.38). The voxels enhanced ratio in the target (T) vs. non-target (NT) areas was greater with RCM (T=98.3% vs. NT=1.7%) than with SEHM (T=89% vs. NT=11%) but the difference was not significant (P=0.30). The total score blindly given by the five interventional radiologists was significantly different between RCM (12.3±2.1 [SD]; range: 6-15) and the standard catheter (11.3±2.5 [SD]; range: 4-15) (P=0.0073), with a significant decrease of non-target embolization for RCM (3.8±1.3 [SD]; range: 3.5-4.2) compared to SEHM (3.2±1.5 [SD]; range: 2.9-3.5) (P=0.014). CONCLUSION: In an animal model, RCM microcatheters reduce the risk of non-target embolization from 11% to 1.7%, increasing the delivery of microspheres of 98% to the target vessels, compared to SEHM microcatheters. ispartof: DIAGNOSTIC AND INTERVENTIONAL IMAGING vol:102 issue:10 pages:641-648 ispartof: location:France status: published

Prostate artery embolization is a well-known and promising treatment for benign prostatic hyperplasia, with the quantum leaps of research in medicine. We aim to provide an up-to-date review of the novel technique, including large retrospective studies and randomized control trials, ends with discussions of advantages and disadvantages of this minimally invasive technique.

Prostate artery embolization (PAE) is a minimally invasive, safe, and effective treatment for benign prostatic hyperplasia. PAE can often be technically challenging due to atherosclerosis and tortuous anatomy, leading to failure of catheterizing one side of prostatic supply, resulting in unilateral PAE, which markedly reduces clinical success. Major anastomosis between both prostatic halves can be exploited for embolizing the entire prostate from a unilateral approach when one side cannot be catheterized. If this anastomosis is extensive enough, clinical success is assumed to be equivalent to bilateral PAE. There is a limited number of published cases in this regard; our case report shows how to detect and exploit this anastomosis.

Few studies on prostate artery embolization (PAE) follow patients up after 12 months. We aimed to evaluate the symptomatic efficacy of PAE in our patient cohort at 3 years. A total of 48 consecutive patients undergoing PAE from June 2012 to August 2014 were included in this retrospective study. All patients underwent formal urodynamics to confirm bladder outflow obstruction prior to PAE. International Prostate Symptom Score (IPSS) was performed at baseline, 3 months, 12 months and 3 years post-PAE. Mean patient age was 65.6 ± 7.4, prostate volume 99.1 ± 56.6 cm3, IPSS 23.5 ± 6.0, quality-of-life score 4.6 ± 0.9, Qmax 8.4 ± 2.8 ml/s, post-void residual volume 185.8 ± 55.6 ml. Technical success (bilateral embolization) was achieved in 43 out of 48 cases (89.6%). 11/39 bilateral PAE patients completing follow-up (2 died, 2 lost to follow-up) underwent surgery, indicating a 71.8% clinical success rate at 3 years. No significant change was demonstrated in IPSS or QOL between 1 and 3 years for patients free from surgical intervention (IPSS 8.3 vs 10.0, p = 0.09 and QOL 1.3 vs 1.5, p = 0.23). 3/11 patients undergoing surgery had a prominent ‘ball-valve’ median lobe, and 1/11 patients had a high bladder neck elevation contributing to symptoms. Clinical success post-PAE remains high with few patients opting for surgery or experiencing a worsening of symptoms after 12 months.

Purpose To demonstrate the feasibility of using a susceptibility-based MRI technique with multi-echo gradient and spin echo (MEGSE) sequence to achieve simultaneous R2, R2' and R2* measurement and assess skeletal muscle oxygenation alternations in a rabbit model of unilateral artery embolization. Materials and Methods Approved by the local institutional review board for experimental animal studies, nine New Zealand White rabbits were included in this study. The MEGSE sequence consists of embedding a set of gradient echoes around the echo of a single spin-echo sequence using several gradient echoes to collect the magnetization intensity during the formation and attenuation of spin-echo simultaneously after 180° radio frequency pulse. Within-session and between-day tests were conducted to evaluate the reproducibility of this skeletal muscle oxygenation alternations measurement. Furthermore, all the MEGSE scans of skeletal muscle were conducted using a 3-T clinical MRI scanner during resting state (before unilateral artery embolization operation, pre), 1 h after unilateral artery embolization operation (post1) and 2 h after unilateral artery embolization operation (post2) model to verify the feasibility and sensitivity of this method. Results The within-session coefficient of variations (CVs) of R2, R2' and R2* measurements were 1.57%, 3.33% and 2.57%, while the between-day CVs of were 1.42%, 5.85% and 2.85%. In all rabbits, the mean R2 decreased significantly from 36.46 ± 1.03 s−1 (pre) to 30.58 ± 2.11 s−1 (post1,**P 0.05). Conclusion This study demonstrates the feasibility of simultaneous R2, R2' and R2* measurement method for the evaluation of skeletal muscle ischemia. Besides, this study indicates the sensitivity of the R2 and R2' compared with R2* and especially the necessity of R2 and R2' measurement for the further evaluation of skeletal muscle ischemia which always causes both edema and hypoxia in a rabbit model of unilateral artery embolization.

Background: Transurethral resection of the prostate (TURP) is ‘Gold Standard’ treatment for moderate-to-severe lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) with blad...

Benign prostatic hyperplasia is a common condition affecting elderly men and leading to lower urinary tract symptoms (LUTS). Prostatic artery embolization (PAE) is a minimally invasive treatment option performed by interventional radiologists, which is emerging as a safe and effective alternative to traditional surgical options in the management of men with LUTS. A detailed understanding of pelvic arterial anatomy, its variations and anastomosis is imperative to perform this procedure safely and to achieve desired treatment outcomes. Advanced imaging techniques which include fluoroscopy, subtraction angiography and cone-beam computed tomography have become standard practice when performing PAE. In this article, the authors focus on the role of imaging in preoperative, intraoperative and postoperative settings while planning and performing prostate artery embolization.

Increased number of left ventricular assist device placement in patients with end stage heart failure as well as years of survival increases the likelihood of need for non-cardiac procedures. Prostate artery embolization is a safe, minimally invasive procedure performed in the setting of lower urinary tract symptoms or refractory gross hematuria of prostatic origin. These patients require a multidisciplinary approach to weigh the benefits and risks of the procedure and provide optimal periprocedural care. We report a case of technically successful prostate artery embolization performed in a patient with HeartWare HVAD presenting with refractory hematuria of prostatic origin (RHPO).

This review focuses on the use of “new” generation of non-adhesive liquid embolic agents (NALEA). In literature, non-adhesive liquid embolic agents have mainly been used in the cerebral district; however, multiple papers describing the use of NALEA in the extracranial district have been published recently and the aim of this review is to explore and analyze this field of application. There are a few NALEA liquids such as Onyx, Squid, and Phil currently available in the market, and they are used in the following applications: mainly arteriovenous malformations, endoleaks, visceral aneurysm or pseudoaneurysm, presurgical and hypervascular lesions embolization, and a niche of percutaneous approaches. These types of embolizing fluids can be used alone or in combination with other embolizing agents (such as coils or particles) so as to enhance its embolizing effect or improve its possible defects. The primary purpose of this paper is to evaluate the use of NALEAs, predominantly used alone, in elective embolization procedures. We did not attempt a meta-analysis due to the data heterogeneity, high number of case reports, and the lack of a consistent follow-up time period.

There are active debates surrounding patient evaluation and procedural techniques of prostate artery embolization. This review evaluates the available evidence on the value of urodynamics, the effect of prostate gland size, the benefits of pre- and intraprocedural cross-sectional imaging, the utility of a balloon-occlusion microcatheter, the differences among embolic particle sizes and types, and the merits of radial versus femoral arterial access.

Prostate artery embolization (PAE) is a minimally invasive treatment for benign prostatic hyperplasia associated lower urinary tract symptoms. The prostatic arterial anatomy, origins and collaterals, are highly variable and can lead to technical pitfalls and suboptimal results during PAE. In this paper we aim to discuss the variant prostate artery origins and collateral circulation to provide a primer on relevant anatomy for interventional radiologists performing PAE.

The graft nephrectomy is burdened by immunological and surgical complications. The main surgical complications of graft nephrectomy are hemorrhage, infections, vascular injury and death. The mortality is high, with percentages varying between 1.3 and 38%. Therefore, graft nephrectomy should be recommended only in selected cases. We conducted a retrospective study, comparing the data of 26 patients undergoing an allograft nephrectomy (2009–2013), without embolization of the renal artery (NO EMBO group) with the data of 40 patients undergoing an allograft nephrectomy (2014–2019), with embolization of the renal artery (EMBO group). We included only graft nephrectomies performed at least 6 months after transplantation. The patients included in the study were consecutive because until 2013 we did not perform the embolization of the renal graft artery. Afterwards, from 2014, instead, we routinely carry out embolization to all patients to be subjected to graft nephrectomy. We, therefore, wanted to analyze whether this surgical approach compared to the previous technique can lead to an improvement in morbidity and mortality, reducing the risk of bleeding and operating times. The examination of our data highlights that embolization of renal artery reduces the operating times of the explant, in addition the group subjected to embolization had less changes in hemoglobinemia and less blood loss.

ObjectiveTo determine whether prostate artery embolization (PAE) is a cost-effective alternative to transurethral resection of the prostate (TURP) in the management of benign prostate hyperplasia (BPH) after 1-year follow-up.Design, setting and main outcome measuresA retrospective cost-utility analysis over a 12-month time period was conducted to compare the two interventions from a National Health Service perspective. Effectiveness was measured as quality-adjusted life years (QALYs) derived from data collected during the observational UK Register of Prostate Embolisation (UK-ROPE) Study. Costs for both PAE and TURP were derived from University Hospital Southampton, a tertiary referral centre for BPH and the largest contributor to the UK-ROPE. An incremental cost-effectiveness ratio (ICER) was derived from cost and QALY values associated with both interventions to assess the cost-effectiveness of PAE versus TURP. Further sensitivity analyses involved a decision tree model to account for the impact of patient-reported complications on the cost-effectiveness of the interventions.ResultsThe mean patient age for TURP (n=31) and PAE (n=133) was 69 and 65.6 years, respectively. In comparison to TURP, PAE was cheaper due to shorter patient stays and the lack of necessity for an operating theatre. Analysis revealed an ICER of £64 798.10 saved per QALY lost when comparing PAE to TURP after 1-year follow-up.ConclusionOur findings suggest that PAE is initially a cost-effective alternative to TURP for the management of BPH after 1-year follow-up. Due to a higher reintervention rate in the PAE group, this benefit may be lost in subsequent years.Trial registration numberNCT02434575.

Introduction: This study aimed to assess the midterm outcomes and safety of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH). Methods: A single-center, retrospective review of PAE performed for BPH was performed. Validated International Prostate Symptom Score (IPSS), quality of life (QoL) index, and International Index for Erectile Function (IIEF-5) questionnaires were completed at baseline and at least 12 months post-procedure. Prostate imaging was performed preprocedure as well as 3 months and 12 months post-procedure to assess prostate volume (PV). Uroflowmetry was also performed at baseline and 12 months post-procedure to assess urine flow rate (Qmax) and post-void residual (PVR) volume. Adverse events were graded according to Society of Interventional Radiology (SIR) guidelines. Results: Eighty male patients underwent the PAE procedure (mean age 69 years). Prostate volume decreased significantly from a mean volume 156 to 107 mL after 12 months post-procedure, commensurate with a mean reduction of 27.5% ( P < .05). Significant improvements were seen in IPSS (21.8 vs 10.5) and QoL (4.5 vs 2.0) from baseline to 12 months post-procedure ( P < .05). There was no significant change in IIEF-5 score. There was a significant reduction in PVR (202 vs 105 mL) and improvement in Qmax (5.9 vs 10.0 mL/s) between baseline and 12 months post-procedure ( P < .05). No major complications occurred; 4 minor complications occurred (SIR grade A or B). Conclusion: Prostate artery embolization achieved a clinically and statistically significant prostate volume reduction, symptom and QoL improvement, and enhanced uroflowmetry parameters in patients with BPH.

This study aimed to evaluate the feasibility of the prostate artery embolization (PAE) in the management of patients with benign prostatic hyperplasia (BPH) in different age groups, depending on the severity of voiding dysfunction, findings of the prostate ultrasound, and the ASA surgical risk. MATERIALS AND METHODS The study comprised 39 patients with grade II-III BPH. Patients were divided into three groups, depending on the prostate volume and the grade of anesthesia risk. Patients of the group 1 (n=12), group 2 (n=19), and group 3 (n=8) underwent a classical transvesical prostatic adenomectomy (TPA), bipolar transurethral resection (TUR) of the prostate, and PAE, respectively. The treatment outcomes were assessed at 3 and 6 months after the operation. RESULTS When comparing the outcomes in three groups, a statistically significant difference in the IPSS was found both at 3 and 6 months when comparing TPA and TUR groups (p

Prostate artery embolization (PAE) is a promising new treatment option for men with symptomatic benign prostatic hyperplasia (BPH). Our goal is to review the data on PAE with regard to outcomes, risks versus benefits, and safety. Current data suggests that PAE is safe and effective for men with symptomatic BPH. The two most robust randomized controlled trials comparing PAE with TURP both found comparable short-term results with regard to improvements in symptoms. However, the side effects of PAE were higher than those of TURP. There remain ongoing randomized controlled trials comparing the two modalities of treatment. Though the largest randomized controlled trials comparing these two modalities of treatment of BPH are still underway, current data suggest PAE may be a promising, safe, and effective treatment option for men with symptomatic BPH. Additionally, PAE can be safely performed on larger prostates of any size and is generally performed via a single, femoral artery puncture under local anesthesia. Therefore, it is particularly appealing for patients with prostate glands > 80 g and who are poor candidates for general anesthesia.

Background: The experience with uretero-arterial fistulas has been limited. However, the aggressive treatment of pelvic tumors with surgical resection and radiotherapy, along with liberal use of ureteral catheters, has been attributed to an increase in their incidence. Unless they are promptly diagnosed and treated, uretero-arterial fistulas are associated with considerably high rates of morbidity and mortality. Urologists need maintain a high degree of suspicion for uretero-arterial fistula in high-risk patients. We herein present the clinical course of an iliac artery-uretero-colonic fistula. Case Presentation: A 67-year-old woman with a history of colon cancer who underwent laparoscopic high anterior resection in July 2010. A ureteral stent inserted to right ureteral stricture, which developed as a result of local recurrence of the tumor in September 2010. She had undergone chemoradiotherapy, but the lesion had slowly increased in size. During the replacement of the ureteral stent in April 2016, she immediately experienced bladder tamponade, bloody bowel discharge, and hypotension. Contrast CT revealed a complex fistula between the right distal ureter and the right internal iliac artery. Furthermore, contrast medium flowed into the intestinal tract through the tumor. The patient was therefore diagnosed with internal iliac artery-uretero-colonic fistula. Arteriography revealed a right uretero-internal iliac artery fistula, and the embolization of the right internal iliac artery was performed. The right ureteral stent was removed. Her hematuria and bloody bowel discharge disappeared, but right nephrostomy was performed because she presented with acute pyelonephritis to ureteral obstruction. Conclusion: In the present case, the uretero-arterial fistula was caused by the long use of an indwelling stent, chemoradiotherapy, infection, and an increase in the size of the lesion. When a suspected uretero-arterial fistula is accompanied by bloody bowel discharge, we should consider the possibility of traffic to the intestinal tract.

Aim: Prostate artery embolization (PAE) is a non invasive modality for the treatment of benign prostate hypertrophy (BPH) related lower urinary tract symptoms (LUTS). As a relatively new procedure, data determining the clinical success is somehow scarce. In the present article we examine the current clinical outcome measures in order to identify the most accurate. Results: Current imaging outcome measures are consistent with clinical ones only in the group of patients with adenomatous- dominant BPH while are inconsistent in patients with small sized adenomas. Conclusions: Additional studies and/or evaluation tools are needed in order to provide accurate evaluation of clinical success in the subgroup of patients with non- adenomatous-dominant BPH while they may inspire new options and novel techniques for both BPH treatment and treatment-follow up.

Lower urinary tract symptoms (LUTS) due to benign prostatic hypertrophy (BPH) are a very common problem in men ranging from mild urinary symptoms to recurrent urinary tract infections or renal failure. Numerous treatment options are available ranging from conservative medical therapies to more invasive surgical options. Prostate artery embolization (PAE) has emerged as a novel treatment option for this common problem with clinical efficacy comparable to the current surgical gold standard, transurethral resection of the prostate (TURP). PAE offers fewer complications and side effects without a need for general anesthesia or hospitalization. This review discusses the indications for prostate artery embolization in addition to LUTS, patient evaluation in patients with LUTS, PAE technique and clinical results, with an emphasis on efficacy and safety.

Clinical/methodical issue In the treatment of the benign prostatic hyperplasia (BPH) medical and surgical therapies have been established. Standard radiological methods Prostate artery embolization (PAE) is an innovative endovascular technique that might close the gap between both these procedures. Performance The PAE procedure is safe and has a low incidence of side effects. The efficacy of PAE has been proven for medium sized and large sized glands as well as for intravesical protrusions. Achievements The complex mechanism of PAE carries the potential to cure lower urinary tract symptoms as well as to retard the progression of the hyperplasia. Practical recommendations Data concerning the long-term efficacy are missing at present.

Treatment of benign prostatic hyperplasia is an important and challenging problem of modern medicine. One of the most modern methods of the treatment of this disease is prostatic artery embolization. This procedure is most often done through transfemoral approach. Transradial vascular access has many advantages over the transfemoral access. Our study presents a comparative analysis of the use of transradial and transfemoral approach in this type of interventions. Transradial access was used in 13 patients, and transfemoral access - in 12 patients. The success of the procedure was 100% in both groups. The total duration of the procedure, the time needed for catheterization of internal iliac and prostatic arteries and the radiation exposure were significantly lower in the transradial approach group. There were no significant differences in the incidence of complications between two groups. The use of the transradial access was associated with a significant reduction of the frequency and severity of the discomfort associated with the procedure. Transradial approach has numerous advantages over the transfemoral approach and may have great clinical significance.

Purpose: Uterine artery embolization (UAE) is an effective treatment for the management of symptomatic uterine fibroids. We aim to evaluate the efficacy of superior hypogastric nerve block (SHNB) in reducing narcotic analgesia use for postprocedural pain after UAE. Methods: A retrospective review of 88 consecutive patients with symptomatic fibroids who underwent UAE between August 2015 and August 2018 was performed. A total of 44 patients had intraprocedural SHNB and 44 patients had no SHNB. They were placed on a morphine patient-controlled anesthesia (PCA) pump after the procedure and were admitted for overnight observation. The total amount of PCA narcotic analgesia received was recorded for each patient. Additional factors including fibroid size, fibroid location, and patient age were evaluated to determine the predictors of narcotic use reduction after SHNB. Results: The mean amount of postprocedural morphine use was 51.7 mg in patients who did not receive an SHNB versus 35.9 mg in patients who did receive an SHNB ( P = .008), resulting in a 47.2% reduction in narcotic analgesia use in the SHNB cohort. A significant reduction in morphine use with SHNB was associated with fibroid size greater than 5 cm ( P = .009), intramural fibroid location ( P = .04), and patients 45 years or younger ( P = .006). Conclusion: The use of SHNB could significantly reduce the amount of narcotic analgesia required for pain control after UAE with larger intramural fibroids and younger patients as predictors of increased efficacy.

To prospectively evaluate the feasibility and reproducibility of the semiquantitative measurement of the unenhanced area of the prostate by trans-abdominal contrast-enhanced ultrasound (CEUS) performed immediately after prostate artery embolization (PAE) as a prognostic factor of success.Thirty-nine patients with PAE were prospectively included. They all underwent pre- and post-PAE trans-abdominal prostate CEUS. Two readers independently evaluated the pre- and post-PAE unenhanced area using a semiquantitative method: unenhanced areas were measured on 3 different slices (basis, middle, and apex) and reported to the whole prostate area. The mean of the three measures was reported semiquantitatively in classes of ten percent and quartiles. We evaluated correlation with clinical success, at 3 months after PAE, defined as a 25% reduction in the International Prostatic Symptoms Score and a Quality of life 3.Twenty-three patients who had bilateral PAE were analyzed. Pre-PAE trans-abdominal prostate CEUS showed visible early and marked enhancement of the entire prostate in all patients. After PAE, all patients had a semiquantitatively measured unenhanced area 25%. The semiquantitative measurement was found to be highly reproducible, with an interclass correlation 0.8. No correlation was found between the area of unenhanced tissue and clinical success evaluated at 3 months.Trans-abdominal prostate CEUS performed early after PAE provides reproducible results and is a valuable tool to evaluate unenhanced areas of the prostate.3, local non random sample.

Prostate artery embolization (PAE) has emerged as a promising treatment modality for lower urinary tract symptoms in men secondary to benign prostatic hypertrophy since 2000, when its therapeutic effects were first documented in a case report. Since then, multiple studies have shown the efficacy and safety of PAE. Although transurethral resection of the prostate remains the gold standard, new data from randomized control trials comparing PAE with surgical techniques continues to emerge.