In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Charles Nutting about prostatic artery embolization (PAE) in the outpatient-based lab (OBL) setting. Dr. Nutting is an interventional radiologist at Endovascular Consultants in Lone Tree, Colorado. The doctors discuss procedure techniques, patient selection, follow-up care, and benefits of the OBL environment over the hospital.

Dr. Nutting emphasizes that it is important to learn PAE in a hospital setting before transitioning to the OBL. He recommends using consistent equipment to help with the learning process. Dr. Nutting also shares his experience with radiopaque beads in PAE and describes the advantages of seeing the deposition of the beads into the gland. The doctors discuss the potential impact of the 2023 American Urological Association (AUA) Guidelines, which for the first time recognizes PAE for the treatment of symptomatic benign prostatic hyperplasia (BPH), and what this might mean for patient volume and interventional radiology training.

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SHOW NOTES

00:00 - Introduction
03:03 - Impact of New AUA Guidelines on PAE
04:48 - Benefits of PAE for Patients
06:37 - Role of Primary Care Physicians in PAE
08:18 - Practice of PAE in the OBL
19:08 - Role of Urodynamic Studies
22:23 - Challenges of Treating Small Glands
26:11 - Procedure Steps and Techniques
34:19 - Post-Procedure Care and Follow-up
38:33 - The Future of Prostate Embolization

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RESOURCES

Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023:
https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline

Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the UK-ROPE study):
https://pubmed.ncbi.nlm.nih.gov/29645352/

NICE - Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia:
https://www.nice.org.uk/guidance/ipg611

Yttrium-90 Radioembolization in the Office-Based Lab:
https://pubmed.ncbi.nlm.nih.gov/32800662/

Role of Urodynamic Studies in Management of Benign Prostatic Obstruction: A Guide for Interventional Radiologists:
https://www.jvir.org/article/S1051-0443(16)30520-6/fulltext

International Prostate Symptom Score (IPSS):
https://www.urologygroup.com/wp-content/uploads/2019/07/IPSS-Form-Before-Tx-_-BPH.pdf