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Purpose <p>This study evaluated the short-term efficacy and safety of prostatic artery embolization (PAE) using ethylene vinyl alcohol copolymer (EVOH) for symptomatic benign prostatic hyperplasia (BPH) and investigated the impact of EVOH penetration on clinical success.</p> Materials and Methods <p>This retrospective, single-center study analyzed 73 men who underwent EVOH-based PAE. The primary endpoint was 3-month clinical success, defined as an International Prostate Symptom Score (IPSS) &lt; 18 with a ≥ 25% decrease and an IPSS-related QoL score ≤ 3 with ≥ 1-point decrease. Complications were graded according to the Clavien–Dindo and CIRSE classification systems. Final cone-beam CT (CBCT) was performed to identify non-target embolizations (NTEs) and to grade EVOH penetration into each hemiprostate using a 0–3 scale. The Prostatic EVOH Penetration Score (PEPS) categorized whole-prostatic embolization as high (3|3, 3|2), medium (3|1, 2|2), and low (others). The secondary objective was to assess the correlation between PEPS groups and clinical success.</p> Results <p>Three-month clinical success was 88% (64/73), with a median IPSS decrease of − 12 points (Q1, Q3: − 17, − 7; <i>P</i> &lt; 0.001) and a median QoL decrease of − 3 points (Q1, Q3: − 4, − 2; <i>P</i> &lt; 0.001). No major complications occurred; 12/73 (16%) patients experienced minor complications. Eight NTEs were identified in 7/73 (10%) patients, all asymptomatic. Clinical success occurred in all patients with high PEPS (n = 57), in 7/11 (64%) patients with medium PEPS, and in none with low PEPS (n = 5) (<i>P</i> &lt; 0.001).</p> Conclusion <p>EVOH-based PAE is safe and effective at 3&#xa0;months for BPH-related symptoms. PEPS may help better define technical success as a predictor of short-term clinical outcomes.</p> Graphical Abstract <p></p>

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Prostatic Artery Embolization Using Ethylene Vinyl Alcohol Copolymer (EVOH): Efficacy, Safety and Clinical Impact of Liquid Embolic Penetration

  • 期刊论文

  • 发表日期：

    2026年2月25日

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  • Xavier Guerra,
  • Louis Denis le Sève,
  • Olivier Pellerin,
  • Marc al Ahmar,
  • Alessandro di Gaeta,
  • Carole Dean,
  • Marc Sapoval,
  • Tom Boeken

摘要

Purpose

This study evaluated the short-term efficacy and safety of prostatic artery embolization (PAE) using ethylene vinyl alcohol copolymer (EVOH) for symptomatic benign prostatic hyperplasia (BPH) and investigated the impact of EVOH penetration on clinical success.

Materials and Methods

This retrospective, single-center study analyzed 73 men who underwent EVOH-based PAE. The primary endpoint was 3-month clinical success, defined as an International Prostate Symptom Score (IPSS) < 18 with a ≥ 25% decrease and an IPSS-related QoL score ≤ 3 with ≥ 1-point decrease. Complications were graded according to the Clavien–Dindo and CIRSE classification systems. Final cone-beam CT (CBCT) was performed to identify non-target embolizations (NTEs) and to grade EVOH penetration into each hemiprostate using a 0–3 scale. The Prostatic EVOH Penetration Score (PEPS) categorized whole-prostatic embolization as high (3|3, 3|2), medium (3|1, 2|2), and low (others). The secondary objective was to assess the correlation between PEPS groups and clinical success.

Results

Three-month clinical success was 88% (64/73), with a median IPSS decrease of − 12 points (Q1, Q3: − 17, − 7; P < 0.001) and a median QoL decrease of − 3 points (Q1, Q3: − 4, − 2; P < 0.001). No major complications occurred; 12/73 (16%) patients experienced minor complications. Eight NTEs were identified in 7/73 (10%) patients, all asymptomatic. Clinical success occurred in all patients with high PEPS (n = 57), in 7/11 (64%) patients with medium PEPS, and in none with low PEPS (n = 5) (P < 0.001).

Conclusion

EVOH-based PAE is safe and effective at 3 months for BPH-related symptoms. PEPS may help better define technical success as a predictor of short-term clinical outcomes.

Graphical Abstract