Moreira Airton Mota, de Assis André Moreira, Carnevale Francisco Cesar, Antunes Alberto Azoubel, Srougi Miguel, Cerri Giovanni Guido
Interventional Radiology and Endovascular Surgery Department, Radiology Institute, University of Sao Paulo Medical School, 255, Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP, 05403-000, Brazil.
Urology Department, University of Sao Paulo Medical School, 255, Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP, 05403-000, Brazil.
Cardiovasc Intervent Radiol. 2017 Oct;40(10):1490-1500. doi: 10.1007/s00270-017-1765-3. Epub 2017 Aug 9.
Minimally invasive procedures have gained great importance among the treatments for benign prostate hyperplasia (BPH) due to their low morbidity. Prostate artery embolization has emerged as a safe and effective alternative for patients with large volume BPH, not suited for surgery.
Low adverse events rates have been reported following prostate artery embolization and may include dysuria, urinary infection, hematuria, hematospermia, acute urinary retention and rectal bleeding. Although most complaints are reported as side effects, complications can also be superimposed.
The prostate gland is the most common source of complaints following PAE, where the inflammatory process can create a large variety of localized symptoms. Periprostatic organs and structures such as bladder, rectum, penis, seminal vesicle, pelvis, bones and skin may be damaged by nontarget embolization, especially due to the misidentification of the normal vascular anatomy and variants or due to inadvertent embolic reflux. Radiodermatitis may also happen in case of small vessel size, atherosclerosis, the learning curve and long procedure or fluoroscopy times.
Regarding safety, it is pivotal to understand the pathophysiology of adverse events following PAE and their standardized reporting. The aim of this article is to discuss adverse events, their management and to review the current literature.
由于微创操作的低发病率，其在良性前列腺增生（BPH）治疗中变得极为重要。对于不适于手术的大体积BPH患者，前列腺动脉栓塞已成为一种安全有效的替代治疗方法。
前列腺动脉栓塞术后不良事件发生率较低，可能包括排尿困难、泌尿系统感染、血尿、血精、急性尿潴留和直肠出血。尽管大多数不适被报告为副作用，但也可能叠加并发症。
前列腺是PAE术后最常见的不适来源，炎症过程可产生多种局部症状。膀胱、直肠、阴茎、精囊、骨盆、骨骼和皮肤等前列腺周围器官和结构可能因非靶栓塞而受损，尤其是由于正常血管解剖结构和变异的误认或意外栓塞反流。在血管管径小、存在动脉粥样硬化、处于学习曲线阶段以及手术或透视时间长的情况下，也可能发生放射性皮炎。
关于安全性，了解PAE术后不良事件的病理生理学及其标准化报告至关重要。本文旨在讨论不良事件、其处理方法并回顾当前文献。
