We talk with Dr. Blake Parsons about his approach to Radial vs. Femoral access for Prostate Artery Embolization for BPH, including patient selection, device considerations, and practice pearls.



SHOW NOTES

In this episode, Dr. Blake Parsons and our host Dr. Chris Beck discuss access sites for prostate artery embolization, along with advice for visualizing pelvic anatomy, procedural tips, and postoperative care.

We start by comparing radial and femoral access. Dr. Parsons prefers femoral access because it is faster, although both approaches share the same amount of bleeding risk. Radial access may offer more pushability and may be more appropriate for patients with tortuous iliac arteries. Additionally, we discuss the closure methods for each approach TR Band for radial access, and AngioSeal for femoral access.

Since pelvic anatomy varies from patient to patient, it can be challenging and timeconsuming to identify the prostate artery. Dr. Parsons recommends using the obturator and pudendal arteries as landmarks. He also emphasizes that resources like lectures, meetings, papers, and courses can help IRs gain exposure and confidence in the pelvic anatomy.

Finally, we talk about managing patient expectations about postoperative pain and dysuria relief. Dr. Parsons prescribes antibiotics, Medrol Dosepak, and Pyridium. The timeline for improvement in benign prostatic hyperplasia is different in each patient, but improvement can be tracked with the IPSS score at follow up appointments.



RESOURCES

STREAM Meeting: https://www.thestreammeeting.com/



The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets.

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