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前列腺动脉栓塞术治疗伴有留置导尿管的下尿路症状患者的疗效和安全性:一项回顾性多中心研究。

Efficacy and safety of prostate artery embolization for patients with lower urinary tract symptoms and indwelling urinary catheter: A retrospective multicenter study.

机构信息

Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, IMAGINE, 30029 Nîmes, France.

Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, IMAGINE, 30029 Nîmes, France.

出版信息

Diagn Interv Imaging. 2022 Dec;103(12):601-606. doi: 10.1016/j.diii.2022.07.002. Epub 2022 Aug 10.

Abstract

PURPOSE

The purpose of this multicenter study was to evaluate the clinical success at three months of prostate artery embolization (PAE), assess PAE safety in centers with various experiences and identify factors associated with PAE success.

PATIENTS AND METHODS

This multicenter, retrospective study included patients who underwent PAE for lower urinary tract symptoms (LUTS) including those with indwelling urinary catheter. PAE clinical success was defined as either 25% improvement of the International Prostate Symptom Score (IPSS) or 1-point improvement of quality of life (QoL) score, or catheter removal at three months. Multivariable analyses were performed using a logistic regression adjusted on patient variables, technical parameters and center experience in PAE.

RESULTS

A total of 383 men (mean age, 68.4 ± 9.7 [standard deviation] years; range: 46-94) with LUTS, including 99 (25.8%) patients with indwelling urinary catheter, were included in seven centers from January 2017 to March 2019. Five patients reported major complications (1.3%), three (0.8%) penile ulceration, three (0.8%) acute urinary retention, one (0.3%) prostatic abscess, and 56 (14.6%) minor complications. Follow up data were available for 271 patients (center 1: n = 159; other centers: n = 112). Clinical success was reported in 232 patients (85.6%). In multivariable analyses, presence of cardiovascular comorbidities (diabetes, stroke history, myocardial infarction and lower limb artery disease) was the single independent variable inversely associated with PAE clinical success (odds ratio = 0.396; 95% confidence interval: 0.17-0.91; P = 0.029). There was no center effect.

CONCLUSION

Our results show that PAE is safe and effective in centers with various PAE experiences. Cardiovascular comorbidity is the single independent variable associated with PAE failure.

摘要

目的

这项多中心研究的目的是评估前列腺动脉栓塞术(PAE)三个月时的临床疗效,评估在具有不同经验的中心进行 PAE 的安全性,并确定与 PAE 成功相关的因素。

患者和方法

这项多中心回顾性研究纳入了因下尿路症状(LUTS)接受 PAE 治疗的患者,包括留置导尿管的患者。PAE 临床成功定义为国际前列腺症状评分(IPSS)改善≥25%或生活质量(QoL)评分提高≥1 分,或三个月时拔除导尿管。使用逻辑回归分析调整患者变量、技术参数和中心 PAE 经验后,进行多变量分析。

结果

共有 383 名(平均年龄 68.4±9.7 岁[标准差];范围:46-94 岁)LUTS 患者,包括 99 名(25.8%)留置导尿管的患者,于 2017 年 1 月至 2019 年 3 月在 7 个中心接受治疗。5 例患者报告发生重大并发症(1.3%),包括 3 例(0.8%)阴茎溃疡、3 例(0.8%)急性尿潴留、1 例(0.3%)前列腺脓肿和 56 例(14.6%)轻微并发症。有 271 名患者(中心 1:n=159;其他中心:n=112)获得随访数据。232 名患者(85.6%)报告临床成功。多变量分析中,心血管合并症(糖尿病、中风史、心肌梗死和下肢动脉疾病)是与 PAE 临床疗效呈负相关的唯一独立变量(比值比=0.396;95%置信区间:0.17-0.91;P=0.029)。无中心效应。

结论

我们的结果表明,PAE 在具有不同 PAE 经验的中心是安全有效的。心血管合并症是与 PAE 失败相关的唯一独立变量。

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