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Abstract No. 161: Embolization of prostatic benign hyperplasia: Preliminary results
Results: MRI measurements permitted immediate depiction of IRE ablation zones that were hypo-intense within T1weighted images and hyper-intense within T2-weighted and proton-density weighted images. MRI-based measurements were highly correlated with FEM-anticipated ablation zones (intra-class correlation coefficient ⬎ 0.9, p⬍0.001 for T1weighted and T2-weighted images) and histology ablation zone measurements (Pearson’s correlation between T1W measurements and histology: r ⫽ 0.88, p ⬍ 0.001; between T2W measurements and histology: r ⫽ 0.92, p ⬍ 0.001). IRE-induced MRI signal changes were absent in rats with ligated portal vein and hepatic artery. Conclusion: MRI permits immediate depiction of ablated tissue zones for intra-procedural monitoring during IRE ablation procedures. These intra-procedural measurements could potentially be used to elicit repeat application of IRE pulses or adjustments to electrode positions to ensure complete treatment of targeted lesions.
Scientific Session 18 Transplant and GI/GU Interventions
Conclusion: Embolization of the prostatic arteries in patients with symptomatic BPH is a feasible procedure with low morbidity and good outcomes at 1 and 3 months. 4:12 PM
Abstract No. 162
Outcomes of a temporary self-expanding metallic stents for achalasia: A prospective study with a 13-year clinical follow-up Y. Cheng; Shanghai Tenth Hospital of Tongji University, Shanghai, China.
Embolization of prostatic benign hyperplasia: Preliminary results J.M. Pisco1,2, L. Pinheiro3,4, T. Bilhim1,5, M. Duarte1,2, J. Mendes3,4; 1Saint Louis Hospital, Lisbon, Portugal; 2Department of Radiology, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal; 3Department of Urology, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal; 4Curry Cabral Hospital, Lisbon, Portugal; 5Department of Anatomy, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal. Purpose: To evaluate the efficacy, morbidity and outcomes of prostatic artery embolization in patients with symptomatic benign prostatic hyperplasia (BPH). Materials and Methods: Embolization was performed in 12 patients with symptomatic BPH, (mean international prostatic symptom score - IPSS of 21, ages 70-78 - mean 74). 4 patients had bladder catheters. Magnetic resonance, transrectal ultrasound, fluxometry and PSA were performed in each patient before embolization and at 1 and 3 months after embolization. The mean prostatic volume before embolization was 96.3 c.c. Questionnaires were filled before, at 1 and 3 months after the procedure. Before, during and after embolization analgesic and anti-inflammatory drugs were given. Embolization was performed with polyvinyl alcohol particles 200 m, under local anesthesia, with a C2F5 catheter introduced in the hypogastric artery and microcatheter was used for superselective catheterization of the the prostatic vessels. Results: The procedure was successful in 11 of the 12 patients (90.9%). In one patient the prostatic arteries were impossible to catheterize due to tortuosity and atherosclerotic changes. The patients did not feel any pain during or after the procedure except one. The vesical catheter was removed 5 days after the procedure in 2 patients and 10 days in the remaining patients. The symptoms improved in all the 11 patients in whom the embolization was successfully
Materials and Methods: Ninety patients with achalasia (diagnosis by clinical presentation, barium oesophagram, and manometry) were allocated for a temporary SEMS in a diameter of 20 mm (n⫽30, group A), 25 mm (n⫽30, group B) and 30 mm (n⫽30, group C). Data on clinical symptoms, complications and long-term clinical outcomes were collected and follow-up was performed at 6 months, 1-, 3-5, 5-8, 8-10, and ⬎ 10 years postoperatively. Results: Stent placement was successful in all patients. Stent migration was less, and chest pain was higher in Group C than that in Group A and B. The clinical remission rate at 5-8 years, 8-10 years and ⬎ 10 years in group C was higher than that in group A and B, and the clinical failure rate was lower in group C (13%) than that in group A (53%) and B (27%). SEMS in group C resulted in reduced dysphagia score, LES pressure, barium height and width in normal level at all follow-up time periods, whereas increased with follow-up time in group A and B. The primary patency in group C was longer than that in group A and B. Conclusion: A temporary SEMS in a diameter of 30 mm was associated with a superior long-term clinical efficacy as compared with a SEMS in a diameter of 20 mm and 25 mm. 4:24 PM
Abstract No. 163
Radiological image guided Suprapubic Bladder Tube (SPT) insertion: Experience with 549 patients C.G. Cronin, P. Prakash, D.A. Gervais, R. Arellano, P. Mueller; Massachusetts General Hospital, Boston, MA. Purpose: Symptomatic bladder outlet obstruction and neurogenic bladder are common patient complaints, frequently requiring suprapubic bladder tubes (SPT). The purpose of this paper is to describe our institutional experience with minimally invasive radiological image guided percutaneous SPT placement, subsequent SPT exchanges and up-sizes; clinical and technical success and complications encountered. Materials and Methods: This study is a Health Insurance Portability and Accountability Act (HIPPA) compliant S63
TUESDAY
Abstract No. 161
Scientific Sessions
Purpose: To prospective compare the long-term clinical outcomes of a self-expanding metallic stents (SEMS) in the treatment of patients with achalasia.
Tuesday, March 16, 2010 4:00 PM - 6:00 PM Room: 13 4:00 PM
performed (mean decrease in the IPSS of 8.2 points at 1 month and 9.3 points at 3 months). The mean prostate volume decreased from 96.3 to 74.3 cc (22.9%) at 1 month and an additional 9.95% at 3 months. The peak urinary flow rate increased 3.8 mL/sec at 1 month and an additional 1.5 mL/sec at 3 months. 4 patients were in urinary retention before embolization. At the third month all of them urinated without bladder catheter with a mean IPSS of 6.33 and a peak urinary flow rate of 9 mL/sec. There were 2 patients with urinary infections after embolization with no other complications.
Scientific Session 18 Transplant and GI/GU Interventions
Conclusion: Embolization of the prostatic arteries in patients with symptomatic BPH is a feasible procedure with low morbidity and good outcomes at 1 and 3 months. 4:12 PM
Abstract No. 162
Outcomes of a temporary self-expanding metallic stents for achalasia: A prospective study with a 13-year clinical follow-up Y. Cheng; Shanghai Tenth Hospital of Tongji University, Shanghai, China.
Embolization of prostatic benign hyperplasia: Preliminary results J.M. Pisco1,2, L. Pinheiro3,4, T. Bilhim1,5, M. Duarte1,2, J. Mendes3,4; 1Saint Louis Hospital, Lisbon, Portugal; 2Department of Radiology, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal; 3Department of Urology, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal; 4Curry Cabral Hospital, Lisbon, Portugal; 5Department of Anatomy, Faculty of Medical Sciences, New University of Lisbon, Lisbon, Portugal. Purpose: To evaluate the efficacy, morbidity and outcomes of prostatic artery embolization in patients with symptomatic benign prostatic hyperplasia (BPH). Materials and Methods: Embolization was performed in 12 patients with symptomatic BPH, (mean international prostatic symptom score - IPSS of 21, ages 70-78 - mean 74). 4 patients had bladder catheters. Magnetic resonance, transrectal ultrasound, fluxometry and PSA were performed in each patient before embolization and at 1 and 3 months after embolization. The mean prostatic volume before embolization was 96.3 c.c. Questionnaires were filled before, at 1 and 3 months after the procedure. Before, during and after embolization analgesic and anti-inflammatory drugs were given. Embolization was performed with polyvinyl alcohol particles 200 m, under local anesthesia, with a C2F5 catheter introduced in the hypogastric artery and microcatheter was used for superselective catheterization of the the prostatic vessels. Results: The procedure was successful in 11 of the 12 patients (90.9%). In one patient the prostatic arteries were impossible to catheterize due to tortuosity and atherosclerotic changes. The patients did not feel any pain during or after the procedure except one. The vesical catheter was removed 5 days after the procedure in 2 patients and 10 days in the remaining patients. The symptoms improved in all the 11 patients in whom the embolization was successfully
Materials and Methods: Ninety patients with achalasia (diagnosis by clinical presentation, barium oesophagram, and manometry) were allocated for a temporary SEMS in a diameter of 20 mm (n⫽30, group A), 25 mm (n⫽30, group B) and 30 mm (n⫽30, group C). Data on clinical symptoms, complications and long-term clinical outcomes were collected and follow-up was performed at 6 months, 1-, 3-5, 5-8, 8-10, and ⬎ 10 years postoperatively. Results: Stent placement was successful in all patients. Stent migration was less, and chest pain was higher in Group C than that in Group A and B. The clinical remission rate at 5-8 years, 8-10 years and ⬎ 10 years in group C was higher than that in group A and B, and the clinical failure rate was lower in group C (13%) than that in group A (53%) and B (27%). SEMS in group C resulted in reduced dysphagia score, LES pressure, barium height and width in normal level at all follow-up time periods, whereas increased with follow-up time in group A and B. The primary patency in group C was longer than that in group A and B. Conclusion: A temporary SEMS in a diameter of 30 mm was associated with a superior long-term clinical efficacy as compared with a SEMS in a diameter of 20 mm and 25 mm. 4:24 PM
Abstract No. 163
Radiological image guided Suprapubic Bladder Tube (SPT) insertion: Experience with 549 patients C.G. Cronin, P. Prakash, D.A. Gervais, R. Arellano, P. Mueller; Massachusetts General Hospital, Boston, MA. Purpose: Symptomatic bladder outlet obstruction and neurogenic bladder are common patient complaints, frequently requiring suprapubic bladder tubes (SPT). The purpose of this paper is to describe our institutional experience with minimally invasive radiological image guided percutaneous SPT placement, subsequent SPT exchanges and up-sizes; clinical and technical success and complications encountered. Materials and Methods: This study is a Health Insurance Portability and Accountability Act (HIPPA) compliant S63
TUESDAY
Abstract No. 161
Scientific Sessions
Purpose: To prospective compare the long-term clinical outcomes of a self-expanding metallic stents (SEMS) in the treatment of patients with achalasia.
Tuesday, March 16, 2010 4:00 PM - 6:00 PM Room: 13 4:00 PM
performed (mean decrease in the IPSS of 8.2 points at 1 month and 9.3 points at 3 months). The mean prostate volume decreased from 96.3 to 74.3 cc (22.9%) at 1 month and an additional 9.95% at 3 months. The peak urinary flow rate increased 3.8 mL/sec at 1 month and an additional 1.5 mL/sec at 3 months. 4 patients were in urinary retention before embolization. At the third month all of them urinated without bladder catheter with a mean IPSS of 6.33 and a peak urinary flow rate of 9 mL/sec. There were 2 patients with urinary infections after embolization with no other complications.