Abstract No. 599 Comparison of Safety and Feasibility of Prostate Artery Embolization via Transradial Access versus Transfemoral Access: A Single-Center Experience

To expand upon the safety and feasibility of transradial access (TRA) during prostate artery embolization compared with transfemoral access (TFA). 1000 patients who underwent PAE from April 2014 to August 2022 were assessed for procedural outcomes and adverse events. 823 patients (82.3%) underwent TRA and 177 patients (17.7%) underwent TFA. Mean age was 70.2 ± 9.5 years. PAE was performed for patients with lower urinary symptoms, acute urinary retention with indwelling catheter, or hematuria. Radial artery diameter, Barbeau waveform, procedure time, fluoroscopy time, dose-area product (DAP), air kerma and all complications were reviewed. Technical success was defined as catheterization of the bilateral prostatic arteries and bilateral prostatic artery embolization. Exclusion criteria for TRA was radial artery diameter < 2 mm or Barbeau type D. The TRA group had 16.5%, 82.8%, and 0.7% Barbeau A, B, and C, respectively. Adverse events were recorded using the Clavien-Dindo classification. A two-tailed P< 0.05 was considered statistically significant. Technical success was achieved in 798 patients (97.2%) in the TRA group and 167 patients (93.3%) in the TFA group (P = 0.02). Mean procedure time (74.0 ± 35.6 vs. 107.2 ± 57.4 min, P< 0.001), fluoroscopy time (31.0 ± 15.5 vs. 41.6 ± 22.1 min, P< 0.01), DAP (20705.0 ± 15962.3 vs. 31833.2 ± 22124.3 μGy·m2, P< 0.01), and air kerma (1712.6 ± 1716.0 vs. 3028.7 ± 2695.4 mGy, P< 0.01) were lower in the TRA group versus the TFA group. Furthermore, patients undergoing TRA versus TFA had lower access site complications, such as ecchymosis 6 (1%) vs 9 (6.1%) (P< 0.01) and hematomas 5 (0.8%) vs 6 (4%) (P = 0.01), respectively. Three TRA patients experienced TIAs and fully recovered without further intervention or disability. One patient experienced a radial artery occlusion without further symptoms. Transradial PAE is a safe and feasible alternative compared with conventional transfemoral PAE with higher technical success, shorter procedure times, lower radiation exposure, and lower access related complications.