RESUMEN
PURPOSE: Prostate artery embolisation (PAE) is a key treatment for the management of symptomatic benign prostatic hyperplasia (BPH). Common cardiovascular risk factors might be associated with suboptimal outcomes and thus influence patient treatment selection. The aim of the study was to evaluate whether cardiovascular comorbidities affect PAE outcomes. METHODS: Retrospective subset analysis of the UK Registry of Prostate Artery Embolisation (UK-ROPE) database was performed with patients who had a full documented past medical histories including hypertension, diabetes, coronary artery disease (CAD), diabetes and smoking status as well as international prostate symptom score (IPSS) at baseline and at 12 months. Multiple regression was performed to assess for any significant predictors. RESULTS: Comorbidity data were available for 100/216 patients (mean age 65.8 ± 6.4 years), baseline IPSS 20.9 ± 7.0). Regression analysis revealed that the presence of hypertension (53.7% IPSS reduction vs. absence 51.4%, p = 0.94), diabetes (52.6% vs. absence 52.1%, p = 0.6), CAD (59.2% vs. absence 51.4%, p = 0.95), no comorbidities (49.8% vs. any comorbidity present 55.3%, p = 0.66), smoking status (non-smoker, 52.6%, current smoker, 61.5%, ex-smoker, 49.8%, p > 0.05), age (p = 0.52) and baseline Qmax (p = 0.41) did not significantly impact IPSS reduction at 12 months post-PAE. Baseline prostate volume significantly influenced IPSS reduction (≥ 80 cc prostates, 58.9% vs. < 80 cc prostates 43.2%, p < 0.05). CONCLUSION: The presence of cardiovascular comorbidities/smoking history does not appear to significantly impact PAE symptom score outcomes at 12 months post procedure. Our findings suggest that if the prostatic artery can be accessed, then clinical success is comparable to those without cardiovascular comorbidities.
Asunto(s)
Diabetes Mellitus , Embolización Terapéutica , Hipertensión , Síntomas del Sistema Urinario Inferior , Hiperplasia Prostática , Masculino , Humanos , Persona de Mediana Edad , Anciano , Recién Nacido , Próstata/irrigación sanguínea , Estudios Retrospectivos , Resultado del Tratamiento , Hiperplasia Prostática/epidemiología , Hiperplasia Prostática/terapia , Hiperplasia Prostática/complicaciones , Embolización Terapéutica/métodos , Arterias , Comorbilidad , Hipertensión/etiología , Sistema de Registros , Reino Unido/epidemiología , Síntomas del Sistema Urinario Inferior/terapia , Calidad de VidaAsunto(s)
Glucemia/metabolismo , Embolización Terapéutica/métodos , Hipoglucemia/etiología , Insulinoma/terapia , Neoplasias Pancreáticas/terapia , Anciano de 80 o más Años , Angiografía de Substracción Digital , Biomarcadores/sangre , Tomografía Computarizada de Haz Cónico , Humanos , Hipoglucemia/sangre , Hipoglucemia/diagnóstico , Insulinoma/sangre , Insulinoma/complicaciones , Insulinoma/patología , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/sangre , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
CLINICAL INTRODUCTION: A woman in her 30s presented to the emergency department with sudden-onset abdominal pain with hypotension and tachycardia. She gave a history of congenital heart disease for which she had previously undergone multiple operations. On examination she demonstrated right upper quadrant tenderness. She underwent an urgent multiphase CT (figure 1A-C).heartjnl;105/4/275/F1F1F1Figure 1(A) Arterial phase coronal CT. (B) Arterial phase axial CT. (C) Portal venous phase axial CT. QUESTION: What is the underlying liver pathology?Hepatocellular adenomaCholangiocarcinomaHepatocellular carcinomaFocal nodular hyperplasiaHepatoblastoma.
