Mohamed Shaker , MD MSIR , MCIRSE , MPAIRS Ass.Prof. of Interventional Radiology Ain Shams University Cairo-Egypt
Mohamed Shaker , MD MSIR , MCIRSE , MPAIRS
Ass.Prof. of Interventional Radiology Ain Shams University
Cairo-Egypt
Building PAE PracticeBuilding PAE Practice GEST 2012 , New York , USAGEST 2012 , New York , USA
Our team established in June 2012Our team established in June 2012
Building PAE PracticeBuilding PAE Practice Co-operation with urologists Co-operation with urologists
Building PAE PracticeBuilding PAE Practice
- Promoting for the technique in your IR clinic and - Promoting for the technique in your IR clinic and
/or establishing a clinic for PAE/or establishing a clinic for PAE
- Promotion through the media - Promotion through the media
- Promotion through the internet- Promotion through the internet
Targeting the patient
Building PAE PracticeBuilding PAE Practice
Promoting for the technique in your IR Promoting for the technique in your IR
clinic and /or establishing a clinic for PAEclinic and /or establishing a clinic for PAE
Targeting the patient
Building PAE PracticeBuilding PAE Practice
Promotion through the media Promotion through the media
Targeting the patient
Newspapers Articles
TV Medical shows
Building PAE PracticeBuilding PAE Practice
Promotion through the internetPromotion through the internet
Targeting the patient
Facebook Page
Facebook Page
Web Sitewww.prostate-eg.com
Our ProtocolOur Protocol Pelvic US with measurement of PVRUPelvic US with measurement of PVRU Urine analysis +/- urine culture and sensitivityUrine analysis +/- urine culture and sensitivity PSA ; total and free/totalPSA ; total and free/total TRUS TRUS MRIMRI Urine flowmetryUrine flowmetry IPSSIPSS QOLQOL CBC , renal function tests , coagulation profileCBC , renal function tests , coagulation profile
Our TechniqueOur Technique Urinary catheter Urinary catheter Local anesthesiaLocal anesthesia Unilateral right femoral approachUnilateral right femoral approach Catheterize Internal iliac arteries by a 5F Cobra or RUC catheterCatheterize Internal iliac arteries by a 5F Cobra or RUC catheter Oblique view Oblique view Catheterize anterior division.Catheterize anterior division. Rotational angiography with cone beam CT Rotational angiography with cone beam CT Prostatic arteries are selectively catheterized with a 2.7 fr. Prostatic arteries are selectively catheterized with a 2.7 fr.
microcatheter ( Progreat ).microcatheter ( Progreat ). Embolization using PVA particles 150 – 250 μm.Embolization using PVA particles 150 – 250 μm.
Our TechniqueOur Technique
ResultsResults We performed 22 cases to dateWe performed 22 cases to date All cases were technically successfulAll cases were technically successful 20 cases of bilateral embolization and 2 cases of unilateral embolization20 cases of bilateral embolization and 2 cases of unilateral embolization We have just finished our study including our first 14 cases with follow up We have just finished our study including our first 14 cases with follow up
at least for 6 months at least for 6 months Rest of patients were done during last 6 months and are still under follow Rest of patients were done during last 6 months and are still under follow
up .up .
ResultsResults
- Mean IPSS score before PAE was 24.7 and 6 months after PAE was 12.4 with
significant P value of 0.0006 .
ResultsResults
- Mean prostatic volume before PAE by MRI was 84.6 and 6 months after PAE
was 52 with mean volume reduction 38.6 %
ResultsResults
- Mean PVRU before PAE was 78.2 and 6 months after PAE was 8.6 with
significant P value of 0.0007 .
ResultsResults
- Mean Qmax before PAE was 12.2 and 6 months after PAE was 17 with
significant P value of 0.0004 .
ResultsResults
No major complication were recorded.No major complication were recorded.
Minor complication in the form of fungal cystitis took Minor complication in the form of fungal cystitis took
place in 1 patient (7.1%) and was successfully treated place in 1 patient (7.1%) and was successfully treated
by antifungal drugs with suprapubic cystostomy.by antifungal drugs with suprapubic cystostomy.
ConclusionConclusion- PAE is a breakthrough interventional technique , suggested
to be popular as UAE and may replace TURP.
- PAE is a feasible , safe , and highly effective technique ...
Neverthless challenging .
- We need to increase the number of IR doing this technique to
make it more popular and increase the awareness of patients
thus increasing the support in our battle with the urologists
THANK YOU