Bhatia Shivank, Sinha Vishal, Bordegaray Matthew, Kably Issam, Harward Sardis, Narayanan Govindarajan
Department of Vascular and Interventional Radiology, (R-109) PO Box 016960,Miami, FL 33101.
University of Miami Miller School of Medicine, Jackson Memorial Hospital, (R-109) PO Box 016960,Miami, FL 33101.
J Vasc Interv Radiol. 2017 May;28(5):656-664.e3. doi: 10.1016/j.jvir.2017.01.004. Epub 2017 Mar 9.
To determine if coil embolization is a safe adjunctive measure to prevent nontarget embolization during prostatic artery embolization (PAE).
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.
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·m vs 52,100 μGy·m, 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.
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.
确定线圈栓塞术是否为预防前列腺动脉栓塞术（PAE）期间非靶栓塞的安全辅助措施。
对2014年1月至2016年6月期间接受有线圈栓塞术（cPAE）或无线圈栓塞术（nPAE）的PAE患者进行回顾性分析。根据介入放射学会（SIR）指南确定的不良事件和操作变量在两个队列之间进行比较。
122例患者中，32例（26.2%）对39条动脉进行了线圈栓塞，放置线圈以预防非靶栓塞（n = 36）、治疗前列腺动脉外渗（n = 2）以及闭塞前列腺内动静脉瘘（n = 1）。与nPAE相比，cPAE的剂量面积乘积无显著增加（64,516 μGy·m vs 52,100 μGy·m，P = 0.053），但操作时间显著延长（160.1分钟vs 137.1分钟，P = 0.022），透视时间也显著延长（62.9分钟vs 46.1分钟，P = 0.023）。每组均发生1例主要并发症（尿脓毒症）（cPAE，1/32 [3.1%]；nPAE，1/80 [1.3%]）。两例均在静脉使用抗生素2周后得到缓解。1例接受线圈栓塞的患者发生轻微缺血性并发症（1/32 [3.1%]），表现为阴茎头变白，经局部治疗后缓解。在1个月和3个月的随访中，队列之间的主要和次要并发症无统计学显著差异。
虽然线圈栓塞术会导致操作和透视时间增加，但它是一种安全的辅助技术，可闭塞前列腺动脉与盆腔血管系统之间的交通，从而有可能预防非靶栓塞。
