Veyg Daniel, Mohanka Rajat, Rumball Ian P, Liang Richard, Garcia-Reyes Kirema, Bishay Vivian, Fischman Aaron M
Long Island Jewish Medical Center, Northwell Health System, Queens, New York.
New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York.
J Vasc Interv Radiol. 2023 Apr;34(4):578-584.e1. doi: 10.1016/j.jvir.2022.11.025. Epub 2022 Dec 5.
This review was undertaken to compare the clinical outcomes of prostatic artery embolization (PAE) in patients with >80 versus <80 mL prostatic volume (PV) at the 24-month follow-up to determine whether PV predicted the effectiveness or durability of PAE.
The PubMed/MEDLINE database was searched for articles published between 2010 and 2022 using the search term "(prostat∗ artery embolization) AND (long term OR follow-up OR 24-month)." Articles were included if they discussed PAE for benign prostatic hyperplasia (BPH) and reported a minimum follow-up of 24 months. Articles with <10 patients were excluded. A subgroup analysis was performed to evaluate for any difference in clinical outcomes at the 24-month post-PAE follow-up between studies with a mean PV of >80 mL and those with a mean PV of <80 mL.
A total of 14 studies with 2,260 patients were included, all of which demonstrated significant reduction in symptoms at the 24-month follow-up after PAE. Four studies were included as part of the >80-mL PV subgroup (n = 467), and 10 studies were included as part of the <80-mL PV subgroup (n = 1,793). There was a statistically significant difference between the mean preprocedural PV (128.5 vs 64.0 mL; P = .015). At the 24-month follow-up, there were no significant differences between groups across any of the compared parameters. The collective incidence of major adverse events reported in the studies within this review was <1%.
PAE is both safe and durable for patients suffering from BPH and can be effective across a wide range of baseline PVs.
本综述旨在比较前列腺体积（PV）>80 mL与<80 mL的患者在24个月随访时前列腺动脉栓塞术（PAE）的临床结果，以确定PV是否可预测PAE的有效性或持久性。
在PubMed/MEDLINE数据库中检索2010年至2022年间发表的文章，检索词为“(前列腺*动脉栓塞术) AND (长期或随访或24个月)”。如果文章讨论了PAE治疗良性前列腺增生（BPH）且报告了至少24个月的随访，则纳入研究。患者人数<10的文章被排除。进行亚组分析，以评估平均PV>80 mL的研究与平均PV<80 mL的研究在PAE后24个月随访时临床结果的差异。
共纳入14项研究，涉及2260例患者，所有研究均表明PAE后24个月随访时症状显著减轻。4项研究纳入>80 mL PV亚组（n = 467），10项研究纳入<80 mL PV亚组（n = 1793）。术前平均PV存在统计学显著差异（128.5 vs 64.0 mL；P = .015）。在24个月随访时，各比较参数在组间无显著差异。本综述中各项研究报告的主要不良事件总发生率<1%。
PAE对BPH患者既安全又持久，并且在广泛的基线PV范围内均可有效。
