This year-old patient with urinary symptoms associated with BPH and reported low quality of life had a successful PAE to relieve symptoms with no sexual side effects. Fischman walks through the procedure step by step, from insertion of the catheter to use of specialized catheters and wires to reach the prostatic artery, review of the anatomy, and insertion of beads to block the flow of blood to the artery.
Created by. View full profile. Alright so we have a 65 year old male with BPH symptoms include weak stream bacteria. Next slide He has a PSR of 6. Max of six Ml per second and an elevated cadet uh M. Prostate volumes 84 mL. And there's no focal, suspicious lesion to suggest prostate cancer. Next slide. So symptomatic Bph treatment options include prostatectomy, terp trans urethral a blade of techniques trans urethral implants on prostate artery ablation and prostate artery embolization.
Um Next slide considerations in this case for going from a trans radial approach include patient height, whether we have equipment long enough to reach prostate artery, whether we're gonna use balloon occlusion techniques. Um The most patient positioning and the room set up for cone beam ct great. I actually marked the style oid process with a line here. Just so you can see the difference the distance between where we're gonna access which is about an inch above the style oid in this case and you can see how big that artery is.
So this should not be an issue. I already gave a little lidocaine. Um And so we're gonna just center that and we're going to try to access it right above. Ah That dot that I made. This is a needle from the kit. Let's see if I can still do this. You see the needle going into the, into the vessel right there and if you look at the needle, it's actually dripping arterial blood which is perfect and you can let go of it in that situation. This is the wire from the kit. It should go without any resistance.
If you feel resistance you should stop and floral. But I typically don't floor. Oh this is the new uh ideal sheath from Merit. This is It's very similar to the 45 Slender. It's basically the exact same concept that you can put a five French catheter In a four French sheath.
