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Chen Z, Yue Z, Yang K, Shen C, Cheng Z, Zhou X, Li S. Four Ounces Can Move a Thousand Pounds: The Enormous Value of Nanomaterials in Tumor Immunotherapy. Adv Healthc Mater 2023; 12:e2300882. [PMID: 37539730 DOI: 10.1002/adhm.202300882] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/17/2023] [Indexed: 08/05/2023]
Abstract
The application of nanomaterials in healthcare has emerged as a promising strategy due to their unique structural diversity, surface properties, and compositional diversity. In particular, nanomaterials have found a significant role in improving drug delivery and inhibiting the growth and metastasis of tumor cells. Moreover, recent studies have highlighted their potential in modulating the tumor microenvironment (TME) and enhancing the activity of immune cells to improve tumor therapy efficacy. Various types of nanomaterials are currently utilized as drug carriers, immunosuppressants, immune activators, immunoassay reagents, and more for tumor immunotherapy. Necessarily, nanomaterials used for tumor immunotherapy can be grouped into two categories: organic and inorganic nanomaterials. Though both have shown the ability to achieve the purpose of tumor immunotherapy, their composition and structural properties result in differences in their mechanisms and modes of action. Organic nanomaterials can be further divided into organic polymers, cell membranes, nanoemulsion-modified, and hydrogel forms. At the same time, inorganic nanomaterials can be broadly classified as nonmetallic and metallic nanomaterials. The current work aims to explore the mechanisms of action of these different types of nanomaterials and their prospects for promoting tumor immunotherapy.
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Affiliation(s)
- Ziyin Chen
- Department of Urology, China-Japan Friendship Hospital, 100029, Beijing, P. R. China
| | - Ziqi Yue
- Department of Forensic Medicine, Harbin Medical University, 150001, Harbin, P. R. China
| | - Kaiqi Yang
- Clinical Medicine, Harbin Medical University, 150001, Harbin, P. R. China
| | - Congrong Shen
- Department of Urology, China-Japan Friendship Hospital, 100029, Beijing, P. R. China
| | - Zhe Cheng
- Department of Forensic Medicine, Harbin Medical University, 150001, Harbin, P. R. China
| | - Xiaofeng Zhou
- Department of Urology, China-Japan Friendship Hospital, 100029, Beijing, P. R. China
| | - Shenglong Li
- Second Ward of Bone and Soft Tissue Tumor Surgery, Cancer Hospital of Dalian University of Technology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, 110042, Shenyang, P. R. China
- The Liaoning Provincial Key Laboratory of Interdisciplinary Research on Gastrointestinal Tumor Combining Medicine with Engineering, Shenyang, 110042, China
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Abstract
Benign prostatic hyperplasia (BPH) is a condition that primarily affects men between the fourth and seventh decades of life, occurring due to enlargement of the prostate which subsequently causes compression of the prostatic urethra causing chronic obstruction of the urinary outflow tract. BPH can cause significant quality-of-life issues such as urinary hesitancy, intermittency, decreased urinary stream, a sensation of incomplete emptying, dysuria, urinary retention, hematuria, and nocturia. Several medical and surgical treatment modalities are available for the treatment of lower urinary tract symptoms and other BPH-related sequela; however, increasingly prostate artery embolization is being utilized in this patient population. Technical demands for this procedure in this population can be significant. This article describes the optimal techniques, tricks, and advanced imaging techniques that can be used to achieve desired technical outcomes.
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Affiliation(s)
- Ansh Bhatia
- Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, India
| | - Aneesha Maini
- M2 at Georgetown University School of Medicine, Washington, District of Columbia
| | - Shivank Bhatia
- Department of Interventional Radiology, University of Miami, Miami, Florida
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3
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Wang XY, Chai YM, Huang WH, Zhang Y. Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis. World J Clin Cases 2022; 10:11812-11826. [PMID: 36405270 PMCID: PMC9669846 DOI: 10.12998/wjcc.v10.i32.11812] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/28/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Prostate artery embolization (PAE) is a promising minimally invasive therapy that improves lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). Transurethral resection of the prostate (TURP) is the gold standard therapy for LUTS/BPH.
AIM To evaluate the efficacy and safety of PAE vs TURP on LUTS related to BPH.
METHODS A literature review was performed to identify all published articles on PAE vs TURP for LUTS/BPH. Sources included PubMed, Embase, Cochrane library databases, and Chinese databases before June 2022. A systematic review and meta-analysis were conducted. Outcome measurements were combined by calculating the mean difference with a 95% confidence interval. Statistical analysis was carried out using Review Manager 5.3.
RESULTS Eleven studies involving 1070 participants were included. Compared with the TURP group, the PAE group had a similar effect on the International Index of Erectile Function (IPSS) score, Peak urinary flow rate (Qmax), postvoid residual volume (PVR), Prostate volume (PV), prostatic specific antigen (PSA), The International Index of Erectile Function short form (IIEF-5) scores, and erectile dysfunction during 24 mo follow-up. Lower quality of life (QoL) score, lower rate of retrograde ejaculation and shorter hospital stay in the PAE group. There was no participant death in either group. A higher proportion of haematuria, urinary incontinence and urinary stricture was identified in the TURP group.
CONCLUSION PAE may be an appropriate option for elderly patients, patients who are not candidates for surgery, and patients who do not want to risk the potential adverse effects of TURP. Studies with large cases and long follow-up time are needed to validate results.
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Affiliation(s)
- Xiao-Yan Wang
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yu-Meng Chai
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Wen-Hui Huang
- School of Information Science and Engineering, Shandong Normal University, Jinan 250014, Shandong Province, China
| | - Yong Zhang
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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De la Garza-Ramos C, Salei A, Caridi TM. Nononcologic Embolization. Semin Intervent Radiol 2022; 39:416-420. [PMID: 36406022 PMCID: PMC9671682 DOI: 10.1055/s-0042-1758077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The scope of conditions managed by embolization, which was initially used for the treatment of hemorrhage and vascular malformations, is constantly expanding. Apart from oncologic indications, embolization is used to treat a wide range of benign pathology, including uterine fibroids and benign prostatic hyperplasia. While various particulate embolic agents are successfully used for benign embolization, there is growing evidence that unique properties of these may result in different outcomes. This article reviews available evidence comparing various particles used for uterine fibroid embolization and prostate artery embolization. In addition, we provide an overview of periprocedural pharmacology and protocols facilitating same-day discharge for these interventions.
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Affiliation(s)
| | - Aliaksei Salei
- Division of Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Theresa M. Caridi
- Division of Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
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Talaie R, Torkian P, Amili O, Aboufirass Y, Rostambeigi N, Jalaeian H, Golzarian J. Particle Distribution in Embolotherapy, How Do They Get There? A Critical Review of the Factors Affecting Arterial Distribution of Embolic Particles. Ann Biomed Eng 2022; 50:885-897. [PMID: 35524027 DOI: 10.1007/s10439-022-02965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
Abstract
Embolization has tremendously evolved in recent years and has expanded to treatment of a variety of pathologic processes. There has been emerging evidence that the level of arterial occlusion and the distribution of embolic particles may play an important role in the clinical outcome. This is a comprehensive literature review to identify variables that play important role in determination of level of occlusion of blood vessels and distribution of embolic particles. The literature searches between 1996 to 2020 through PubMed and Ovid-MEDLINE yielded over 1030 articles of which 30 studies providing details on the level of occlusion are reviewed here. We divided the playing factors into characteristics of the particles, solution/injection and vascular bed. Accordingly, particle size, type and aggregation, compressibility/deformability, and biodegradability are categorized as the factors involving particles' behavioral nature. Infusion rate and concentration/dilution of the medium are related to the carrying solution. Hemodynamics and the arterial resistance are characteristics of the vascular bed that also play an important role in the distribution of embolic particles. Understanding and predicting the level of embolization is a complex multi-factor problem that requires more evidence, warranting further randomized controlled trials, and powered human and animal studies.
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Affiliation(s)
- Reza Talaie
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Pooya Torkian
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA.
| | - Omid Amili
- Department of Mechanical, Industrial and Manufacturing Engineering (MIME), University of Toledo, Toledo, OH, USA
| | | | - Nassir Rostambeigi
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jafar Golzarian
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA
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Abdul Rahim R, Eng Hong G, Nik Ismail NA, Zakaria R. Outcomes of Prostate Artery Embolisation in Patients with Severe Symptoms of Benign Prostate Hyperplasia. Malays J Med Sci 2022; 28:55-63. [PMID: 35002490 PMCID: PMC8715873 DOI: 10.21315/mjms2021.28.6.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Benign prostatic hyperplasia (BPH) is associated with severe lower urinary tract symptoms (LUTS). The severity of LUTS is assessed by the International Prostate Symptoms Score (IPSS). Prostate artery embolisation (PAE) is a newly available method for combating LUTS. This study aims to assess the outcomes of PAE in reducing LUTS and prostate volume in patients with BPH. Methods Patients diagnosed with BPH with severe LUTS who had undergone PAE were included. Their IPSS score was ≥ 20 despite medical therapy. PAE was performed via the unilateral femoral artery using various types of embolic material. Bilateral or unilateral embolisation of the prostate artery was considered a technical success. The severity of LUTS pre- and post-PAE were assessed using IPSS while prostate volume pre- and post-PAE were assessed by ultrasound and magnetic resonance imaging (MRI). Results Ninety percent of patients had technical success and one required transurethral resection of the prostate (TURP). The mean IPSS reduction at the final follow-up was 12.9 (P < 0.028). The mean reduction of prostate volume at the last follow-up by ultrasound was 114.99 mL (P < 0.028) and by MRI was 29.17 mL (P < 0.028). Conclusion PAE is safe and effective in reducing severe LUTS and prostate gland volume in BPH patients.
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Affiliation(s)
- Rohana Abdul Rahim
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia
| | - Goh Eng Hong
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia
| | - Nik Azuan Nik Ismail
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia
| | - Rozman Zakaria
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia
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Sonmez G, Tolga Tombul S, Herdem N, Demirtas T, Tatlısen A, Demirtas A. Superselective vesical artery embolization versus intravesical formalin for intractable hematuria in patients with bladder cancer. Actas Urol Esp 2021; 46:35-40. [PMID: 34838495 DOI: 10.1016/j.acuroe.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Intractable hematuria is a leading critical problem occurring in patients with advanced stage bladder cancer (BCa) that are not suitable for radical cystectomy. The present study, for the first time in the literature, aimed to compare the effectiveness of intravesical formalin (IF) and superselective vesical artery embolization (SVAE) in the management of intractable and life-threatening hematuria in BCa patients. METHODS The retrospective study included 40 BCa patients who underwent SVAE or IF treatment due to intractable hematuria after failure of other methods. Patients were divided into two groups based on the procedures administered: SVEA Group (n = 24) and IF Group (n = 16). RESULTS The success rate at first-line therapy was 50% (12/24) in SVAE Group and 82% (13/16) in IF Group (p = 0.046). Based on the success rates at first- and second-line therapies, the overall success rate in SVAE Group was 75% and this rate was similar to that of IF Group (p = 0.439). Complication rate was significantly higher in IF patients than in SVAE patients (37.5% vs. 8.3; p = 0.024), whereas duration of postoperative hospital stay was significantly longer in SVAE Group (15.8 vs. 6 days; p = 0.041). CONCLUSION The advantages of IF appear to include shorter postoperative hospital stays and higher success rates at a single session, while the advantages of SVAE seem to include non-requirement of spinal/general anesthesia, easy repeatability, and low complication rates. In the management of patients with intractable hematuria, patients' general condition, comorbidities, and anesthesia-related risks should be taken into consideration.
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Affiliation(s)
- G Sonmez
- Department of Urology, Erciyes University, Kayseri, Turkey
| | - S Tolga Tombul
- Department of Urology, Erciyes University, Kayseri, Turkey
| | - N Herdem
- Department of Radiology, Erciyes University, Kayseri, Turkey
| | - T Demirtas
- Department of Medical History and Ethics, Erciyes University, Kayseri, Turkey
| | - A Tatlısen
- Department of Urology, Erciyes University, Kayseri, Turkey
| | - A Demirtas
- Department of Urology, Erciyes University, Kayseri, Turkey.
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Fu Z, Li X, Cai F, Yuan Y, Zhang X, Qin J, Liang Y. Microspheres present comparable efficacy and safety profiles compared with polyvinyl alcohol for bronchial artery embolization treatment in hemoptysis patients. J Transl Med 2021; 19:422. [PMID: 34635108 PMCID: PMC8504013 DOI: 10.1186/s12967-021-02947-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/17/2021] [Indexed: 12/12/2022] Open
Abstract
Background The present study aimed to compare the efficacy and safety profiles of microspheres versus (vs.) polyvinyl alcohol (PVA) for bronchial artery embolization (BAE) treatment in patients with hemoptysis. Methods Totally, 152 patients with hemoptysis who were about to receive BAE treatment were consecutively enrolled and divided into microspheres group (N = 62) and PVA group (N = 90). Technical success and clinical success were assessed after BAE procedure, and the hemoptysis-recurrence status, survival status and adverse events were recorded during follow-up. Results Technical success rates were both 100% in microspheres group and PVA group; clinical success rate (96.8% vs. 100.0%, P = 0.165), 6-month (9.7% vs. 7.8%, P = 0.681) and 1-year (9.7% vs. 8.9%, P = 0.869) hemoptysis recurrence rate, 6-month (4.8% vs. 2.2%, P = 0.374) and 1-year (4.8% vs. 3.3%, P = 0.639) mortality were similar between microspheres group and PVA group. Furthermore, hemoptysis-free survival (P = 0.488) and overall survival (P = 0.321) were of no difference between two groups. In addition, all adverse events were mild, and there was no difference of adverse events between two groups (all P > 0.05). These data were validated by further multivariate regression analysis. Conclusions Microspheres present comparable efficacy and safety profiles compared with PVA for the BAE treatment in patients with hemoptysis, providing evidence for embolic agent selection. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02947-7.
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Affiliation(s)
- Zhigang Fu
- Department of Radiology, Yichang Central People's Hospital, First College of Clinical Medical Science, China Three Gorges University, 183 Yiling Road, Yichang, 443003, China
| | - Xun Li
- Department of Radiology, People's Hospital of Dangyang country, Dangyang, 444100, China
| | - Fei Cai
- Department of Radiology, Yichang Central People's Hospital, First College of Clinical Medical Science, China Three Gorges University, 183 Yiling Road, Yichang, 443003, China
| | - Yinpeng Yuan
- Department of Radiology, Yichang Central People's Hospital, First College of Clinical Medical Science, China Three Gorges University, 183 Yiling Road, Yichang, 443003, China
| | - Xiaolin Zhang
- Department of Radiology, Yichang Central People's Hospital, First College of Clinical Medical Science, China Three Gorges University, 183 Yiling Road, Yichang, 443003, China
| | - Jingxia Qin
- Department of Radiology, Yichang Central People's Hospital, First College of Clinical Medical Science, China Three Gorges University, 183 Yiling Road, Yichang, 443003, China.
| | - Yonghui Liang
- Department of Radiology, Yichang Central People's Hospital, First College of Clinical Medical Science, China Three Gorges University, 183 Yiling Road, Yichang, 443003, China.
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de Assis AM, Moreira AM, Carnevale FC, Lanz-Luces JR. Prostatic artery embolization for giant prostatic hyperplasia: a single-center experience. Radiol Bras 2021; 54:219-224. [PMID: 34393287 PMCID: PMC8354184 DOI: 10.1590/0100-3984.2020.0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/12/2020] [Indexed: 08/30/2023] Open
Abstract
Objective To describe the safety and efficacy of prostatic artery embolization (PAE) in patients with a markedly enlarged prostate. Materials and Methods This was a retrospective study including 18 consecutive patients (mean age, 74 years) with benign prostatic hyperplasia, all with a prostate volume ≥ 200 cm3, who were enrolled to receive PAE for the treatment of moderate-to-severe lower urinary tract symptoms. Results The PAE procedure was technically successful in 17 patients (94.4%). During follow-up, clinical failure (defined as an International Prostate Symptom Score [IPSS] ≥ 8) was observed in two (11.1%) of those 18 patients. At 3 months of follow-up, there was significant improvement over baseline in all relevant outcome measures: total IPSS (from 15.7 to 2.9); IPSS quality of life score (from 5.2 to 1.0); prostate specific antigen (from 11.4 to 1.82 ng/mL); peak urinary flow rate (from 7.45 to 18.6 mL/s); prostate volume (from 252.4 to 151.6 cm3); and post-void residual volume (from 143.7 to 28.3 mL)-p < 0.05 for all. Of the 18 patients, one (5.6%) presented detachment of prostate tissue and self-limited hematuria, which did not require specific treatment. Conclusion In patients with a markedly enlarged prostate, PAE proved to be safe and effective, resulting in significant improvements in clinical, imaging, and urodynamic parameters.
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Affiliation(s)
- André Moreira de Assis
- Interventional Radiology Department, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
| | - Airton Mota Moreira
- Interventional Radiology Department, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
| | - Francisco Cesar Carnevale
- Interventional Radiology Department, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
| | - José Ramón Lanz-Luces
- Interventional Radiology Department, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
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10
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Sonmez G, Tolga Tombul S, Herdem N, Demirtas T, Tatlısen A, Demirtas A. Superselective vesical artery embolization versus intravesical formalin for intractable hematuria in patients with bladder cancer. Actas Urol Esp 2021; 46:S0210-4806(21)00121-2. [PMID: 34332813 DOI: 10.1016/j.acuro.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Intractable hematuria is a leading critical problem occurring in patients with advanced stage bladder cancer (BCa) that are not suitable for radical cystectomy. The present study, for the first time in the literature, aimed to compare the effectiveness of intravesical formalin (IF) and superselective vesical artery embolization (SVAE) in the management of intractable and life-threatening hematuria in BCa patients. METHODS The retrospective study included 40 BCa patients who underwent SVAE or IF treatment due to intractable hematuria after failure of other methods. Patients were divided into two groups based on the procedures administered: SVEA Group (n=24) and IF Group (n=16). RESULTS The success rate at first-line therapy was 50% (12/24) in SVAE Group and 82% (13/16) in IF Group (p=0.046). Based on the success rates at first- and second-line therapies, the overall success rate in SVAE Group was 75% and this rate was similar to that of IF Group (p=0.439). Complication rate was significantly higher in IF patients than in SVAE patients (37.5% vs. 8.3; p=0.024), whereas duration of postoperative hospital stay was significantly longer in SVAE Group (15.8 vs. 6 days; p=0.041). CONCLUSION The advantages of IF appear to include shorter postoperative hospital stays and higher success rates at a single session, while the advantages of SVAE seem to include non-requirement of spinal/general anesthesia, easy repeatability, and low complication rates. In the management of patients with intractable hematuria, patients' general condition, comorbidities, and anesthesia-related risks should be taken into consideration.
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Affiliation(s)
- G Sonmez
- Department of Urology, Erciyes University, Kayseri, Turquía
| | - S Tolga Tombul
- Department of Urology, Erciyes University, Kayseri, Turquía
| | - N Herdem
- Department of Radiology, Erciyes University, Kayseri, Turquía
| | - T Demirtas
- Department of Medical History and Ethics, Erciyes University, Kayseri, Turquía
| | - A Tatlısen
- Department of Urology, Erciyes University, Kayseri, Turquía
| | - A Demirtas
- Department of Urology, Erciyes University, Kayseri, Turquía.
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Uflacker AB, Haskal ZJ, Baerlocher MO, Bhatia SS, Carnevale FC, Dariushnia SR, Faintuch S, Gaba RC, Golzarian J, Midia M, Nikolic B, Sapoval MR, Walker TG. Society of Interventional Radiology Research Reporting Standards for Prostatic Artery Embolization. J Vasc Interv Radiol 2020; 31:891-898.e1. [PMID: 32340862 DOI: 10.1016/j.jvir.2020.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Andre B Uflacker
- Department of Radiology and Radiological Sciences, Division of Vascular and Interventional Radiology, Medical University of South Carolina, Charleston, South Carolina.
| | - Ziv J Haskal
- Department of Radiology and Medical Imaging/Interventional Radiology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Mark O Baerlocher
- Department of Radiology, Royal Victoria Hospital, Barrie, Ontario, Canada
| | - Shivank S Bhatia
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Francisco C Carnevale
- Department of Interventional Radiology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Sean R Dariushnia
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Salomao Faintuch
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Ron C Gaba
- Department of Radiology, University of Illinois at Chicago, Chicago, Illinois
| | - Jafar Golzarian
- Department of Radiology, Division of Interventional Radiology and Vascular Imaging, University of Minnesota, Minneapolis, Minnesota
| | - Mehran Midia
- Department of Radiology, McMaster University, Joseph Brant Hospital, Burlington, Ontario, Canada
| | - Boris Nikolic
- Department of Interventional Radiology, Cooley Dickinson Hospital, Massachusetts General Hospital Affiliate, Northampton, Massachusetts
| | - Marc R Sapoval
- Department of Interventional Vascular and Oncologic Radiology, Hôpital Européen Georges Pompidou, Paris, France
| | - T Gregory Walker
- Division of Interventional Radiology, Massachusetts General Hospital, Boston, Massachusetts
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12
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Zhang JL, Yuan B, Wang MQ, Fu JX, Duan F, Wang T, Shen L, Wang Y, Liu JH, Shen YG, Wang XQ, Zhang HT, Li HW, Yan JY, Song ZG. Prostatic Artery Embolization for Benign Prostatic Hyperplasia: Bleomycin-Eluting versus Bland Microspheres in a Canine Model. J Vasc Interv Radiol 2020; 31:820-830. [PMID: 32305243 DOI: 10.1016/j.jvir.2019.11.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/14/2019] [Accepted: 11/17/2019] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To prospectively assess safety and efficacy of prostatic artery embolization (PAE) with bleomycin-eluting microspheres for benign prostatic hyperplasia (BPH) in a canine model. MATERIALS AND METHODS Twelve adult male beagles (mean age, 1.6 y ± 0.2; range, 1.2-2.0 y) were randomly assigned to group A (n = 6; PAE with bleomycin-eluting 30-60-μm HepaSphere microspheres) and group B (n = 6; PAE with bland 30-60-μm HepaSphere microspheres) between April 2017 and November 2018. Plasma bleomycin concentration in group A was measured within 7 days. Prostate volume (PV) and ischemic volume after PAE were measured by magnetic resonance imaging. Prostates and adjacent organs were harvested after the last magnetic resonance study and histopathologically examined. RESULTS Plasma bleomycin concentration peaked at 10 minutes at 2,055.0 ng/mL ± 606.1 and lasted for 1,440 min at low levels after PAE. PV reduction percentage was greater in group A than in group B at 1 month (74.1% ± 4.3 vs 63.7% ± 3.5; P = .006) and 3 months (61.5% ± 6.7 vs 46.1% ± 3.8; P = .001) after PAE. Proportion of prostate ischemic volume was greater in group A than in group B (75.3% ± 3.0 vs 62.0% ± 7.1; P = .006) at 1 month after PAE. Proportion of prostate ischemic volume at 1 month positively correlated with PV percentage reduction at 3 months in group A (r = 0.840, P = .036) and group B (r = 0.844, P = .035). There were no complications or nontarget embolization to surrounding organs after the procedures. CONCLUSIONS In a canine model, PAE with bleomycin-eluting microspheres was feasible and well tolerated and caused ischemic necrosis and reduction in PV.
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Affiliation(s)
- Jin Long Zhang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Bing Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Mao Qiang Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China.
| | - Jin Xin Fu
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Feng Duan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Tao Wang
- Academy of Military Medical Sciences, Institute of Pharmacology and Toxicology, Beijing, P.R. China
| | - Liao Shen
- Academy of Military Medical Sciences, Institute of Pharmacology and Toxicology, Beijing, P.R. China
| | - Yan Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Jin Hong Liu
- Department of Pathology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Yan Guang Shen
- Department of Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Xiu Qi Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Hong Tao Zhang
- Department of Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Hong Wei Li
- Department of Urology Surgery, Second Hospital of Beijing Municipality, Beijing, P.R. China
| | - Jie Yu Yan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Zhi Gang Song
- Department of Pathology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
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Cui L, Bai Y, Zhang J, Yuan B, Wang X, Wang Y, Duan F, Wang M. Prostatic artery embolization: Progress and prospect. J Interv Med 2020; 3:77-79. [PMID: 34805911 PMCID: PMC8562249 DOI: 10.1016/j.jimed.2020.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Li Cui
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
| | - Yanhua Bai
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
| | - Jinlong Zhang
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
| | - Bing Yuan
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
| | - Xiuqi Wang
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
| | - Yan Wang
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
| | - Feng Duan
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
| | - Maoqiang Wang
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China
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14
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Al Rawashdah SF, Pastore AL, Velotti G, Fuschi A, Capone L, Suraci PP, Martoccia A, Saltarelli A, Minucci S, Falsaperla M, Al Salhi Y, Illiano E, Costantini E, Carbone A. Sexual and functional outcomes of prostate artery embolisation: A prospective long-term follow-up, large cohort study. Int J Clin Pract 2020; 74:e13454. [PMID: 31769906 DOI: 10.1111/ijcp.13454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/22/2019] [Indexed: 01/28/2023] Open
Abstract
AIM OF THE STUDY Among minimally invasive procedures for treating benign prostate hyperplasia (BPH) prostate artery embolisation (PAE) is described as safe and effective. Aim of this study is to report our results, focusing on sexual outcomes (erectile and ejaculatory functions sparing) of PAE in patients suffering from bladder outlet obstruction (BOO) secondary to BPH. METHODS We prospectively enrolled and submitted to PAE subjects suffering from BOO secondary to BPH. All patients were not suitable for surgery or declined invasive approaches. All subjects were preoperatively and postoperatively (3, 6, 12 and 18 months after) evaluated by urinary flowmetry, post voiding residual volume, prostate volume, serum PSA levels, International Index of Erectile Function, International Prostate Symptom Score and QoL scores. RESULTS PAE was performed in 147 patients (mean age 72.5 y.o.). PAE was technically successful in all patients. The procedure lasted a mean time of 94.3 minutes, with a mean fluoroscopic time of 42.5 minutes. Twelve months follow-up data were available for all patients, while 126 patients (85%) completed the 18 months follow up. At 12 months follow up, the mean IPSS and QoL scores significantly decreased, and all the objective parameters (mean Qmax, PVR and prostate volume) reported a significant improvement. A total of 130 patients (88.5%) at 12 months reported the antegrade ejaculation preserved, and a slight not significant improvement of IIEF scores. The 18 months after PAE outcomes confirmed the significant improvement of all the variables evaluated (even for PSA values and IIEF scores). No major complications occurred. CONCLUSIONS Our results evidence prostate artery embolisation as highly feasible and safe procedure with interesting outcomes. In particular, in our study PAE reported promising results in preserving antegrade ejaculation and erectile function. Our data are in line with the literature, confirming how PAE reduces obstructive symptoms in BPH patients not suitable or refusing standard surgical approaches.
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Affiliation(s)
| | - Antonio Luigi Pastore
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
| | - Gennaro Velotti
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
| | - Andrea Fuschi
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
| | - Lorenzo Capone
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
| | - Pietro Paolo Suraci
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
| | - Alessia Martoccia
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
| | | | - Sergio Minucci
- Radiology Unit, San Carlo di Nancy Hospital, Rome, Italy
| | | | - Yazan Al Salhi
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
| | - Ester Illiano
- Department of Urology, AOU Santa Maria Terni, University of Perugia, Terni, Italy
| | | | - Antonio Carbone
- Department of Medico-Surgical Biotechnologies, Department of Urology, Sapienza University of Rome, Latina, Italy
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15
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Wang CY, Hu J, Sheth RA, Oklu R. Emerging Embolic Agents in Endovascular Embolization: An Overview. PROGRESS IN BIOMEDICAL ENGINEERING (BRISTOL, ENGLAND) 2020; 2:012003. [PMID: 34553126 PMCID: PMC8455112 DOI: 10.1088/2516-1091/ab6c7d] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Courtney Y. Wang
- The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St., Hourson, TX 77030, USA
| | - Jingjie Hu
- Division of Vascular and Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ 85259, USA
| | - Rahul A. Sheth
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
| | - Rahmi Oklu
- Division of Vascular and Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ 85259, USA
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16
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Affiliation(s)
- Samdeep Mouli
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois
| | - Elias Hohlastos
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois
| | - Riad Salem
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois
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17
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Zhang JL, Wang MQ, Shen YG, Ye HY, Yuan K, Xin HN, Zhang HT, Fu JX, Yan JY, Wang Y. Effectiveness of Contrast-enhanced MR Angiography for Visualization of the Prostatic Artery prior to Prostatic Arterial Embolization. Radiology 2019; 291:370-378. [PMID: 30806596 DOI: 10.1148/radiol.2019181524] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background A major technical challenge of prostatic arterial embolization (PAE) is the identification and catheterization of the prostatic arteries (PAs). Recently, MR angiography has been shown to help visualize PAs, but the clinical utility of MR angiography for this purpose is not known. Purpose To determine the efficacy of contrast material-enhanced MR angiography in identifying the PA and to evaluate its role in PAE for benign prostatic hyperplasia (BPH). Materials and Methods In this prospective study, 100 consecutive men who were scheduled to undergo PAE for BPH from January 2015 to May 2017 were assigned by using a randomized block design to either group A (n = 50; mean age, 71.7 years ± 11.9 [standard deviation]) without MR angiography or group B (n = 50; mean age, 72.3 years ± 12.2) with MR angiography prior to PAE. MR angiography findings of the PA anatomy were compared with those of digital subtraction angiography (DSA). The Student t test and Wilcoxon rank-sum test were used to compare the differences between the parameters indicating the performance of PAE. Results The mean age of the 100 men in the study was 72.0 years ± 11.8 (range, 51-88 years). Compared with DSA as the reference standard, MR angiography identified PAs with a sensitivity of 91.5% (97 of 106) and a positive predictive value of 100% (97 of 97). With the knowledge of tube obliquity and anatomy, group B had lower procedure times than group A (82.3 minutes ± 5.4 vs 123.9 minutes ± 12.4, P < .001) and shorter fluoroscopy times (13.8 minutes ± 2.7 vs 28.5 minutes ± 8.0, P < .001). Additionally, radiation dose was reduced for group A versus group B, from a median of 920 to 339 mGy (P = .004). Conclusion Contrast-enhanced MR angiography can accurately show anatomy for the prostate arteries, leading to shorter prostatic artery embolization times and lower radiation dose than when preprocedural prostate MR angiography is not performed. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Prince in this issue.
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Affiliation(s)
- Jin Long Zhang
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Mao Qiang Wang
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Yan Guang Shen
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Hui Yi Ye
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Kai Yuan
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Hai Nan Xin
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Hong Tao Zhang
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Jin Xin Fu
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Jie Yu Yan
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
| | - Yan Wang
- From the Departments of Interventional Radiology (J.L.Z., M.Q.W., K.Y., H.N.X., J.X.F., J.Y.Y., Y.W.) and Radiology (Y.G.S., H.Y.Y., H.T.Z.), Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR China
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Salem R, Hairston J, Hohlastos E, Riaz A, Kallini J, Gabr A, Ali R, Jenkins K, Karp J, Desai K, Thornburg B, Casalino D, Miller F, Hofer M, Hamoui N, Mouli S. Prostate Artery Embolization for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Results From a Prospective FDA-Approved Investigational Device Exemption Study. Urology 2018; 120:205-210. [DOI: 10.1016/j.urology.2018.07.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/02/2018] [Accepted: 07/06/2018] [Indexed: 11/30/2022]
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