Prostate Artery Embolization

Over the past decade, prostate artery embolization (PAE) has emerged as a minimally invasive treatment option for patients suffering from lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Literature over that time has moved from discussion of technique and technical feasibility of the procedure to comparisons of PAE with traditional surgical therapies such as transurethral resection of the prostate (TURP). In most studies of patients undergoing PAE, transfemoral arterial access was obtained to catheterize the prostatic arteries. More recently, the use of transradial access to perform PAE has been described. While technically challenging, the transradial technique offers several potential advantages in appropriately selected patients, which may improve the benefit-risk profile of PAE and improve patient satisfaction. We describe the history and applications of PAE, list the equipment needed to perform PAE, review the procedural steps and technical considerations, and provide a case example, all in the context of transradial access.