Carnevale Francisco Cesar, McClure Timothy, Cadour Farah, Vidal Vincent, de Assis André Moreira, Moreira Airton Mota, Rocha Arthur Diego Dias, Rebet Aya, Nutting Charles
Department of Radiology, University of Sao Paulo Medical School, Av. Dr. Enéas Carvalho de Aguiar, 255, São Paulo, SP, 05403-000, Brazil.
Weill Cornell Medicine, New York, NY, USA.
CVIR Endovasc. 2021 Aug 10;4(1):63. doi: 10.1186/s42155-021-00249-z.
Prostatic artery embolization (PAE) is associated with patients' quality of life improvements and limited side effects compared to surgery. However, this procedure remains technically challenging due to complex vasculature, anatomical variations and small arteries, inducing long procedure times and high radiation exposure levels both to patients and medical staff. Moreover, the risk of non-target embolization can lead to relevant complications. In this context, advanced imaging can constitute a solid ally to address these challenges and deliver good clinical outcomes at acceptable radiation levels.
This technical note aims to share the consolidated experience of four institutions detailing their optimized workflow using advanced image guidance, discussing variants, and sharing their best practices to reach a consensus standardized imaging workflow for PAE procedure, as well as pre and post-operative imaging.
This technical note puts forth a consensus optimized imaging workflow and best practices, with the hope of helping drive adoption of the procedure, deliver good clinical outcomes, and minimize radiation dose levels and contrast media injections while making PAE procedures shorter and safer.
与手术相比,前列腺动脉栓塞术(PAE)可改善患者生活质量且副作用有限。然而,由于血管系统复杂、解剖变异以及动脉细小,该手术在技术上仍具有挑战性,导致手术时间长,患者和医护人员所受辐射暴露水平高。此外,非靶栓塞风险可能导致相关并发症。在此背景下,先进成像技术可成为应对这些挑战并在可接受的辐射水平下实现良好临床结果的有力帮手。
本技术说明旨在分享四个机构的综合经验,详细介绍它们使用先进图像引导的优化工作流程,讨论变异情况,并分享最佳实践,以达成PAE手术以及术前和术后成像的共识标准化成像工作流程。
本技术说明提出了一种共识优化成像工作流程和最佳实践,希望有助于推动该手术的应用,实现良好临床结果,在缩短PAE手术时间并使其更安全的同时,将辐射剂量水平和造影剂注射量降至最低。