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BackTable Vascular & Interventional
Ep. 416 PAE in the OBL with Dr. Charles Nutting
Feb 13, 2024
Dr. Charles Nutting, interventional radiologist, discusses prostatic artery embolization (PAE) in the outpatient-based lab (OBL), emphasizing the importance of learning PAE in a hospital setting before transitioning to the OBL. They also discuss the advantages of using radiopaque beads in PAE and the potential impact of the 2023 AUA Guidelines. The podcast covers procedure techniques, patient selection, and benefits of the OBL environment over the hospital.
46:39
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Quick takeaways
- The inclusion of prostatic artery embolization (PAE) in the American Urological Association guidelines is expected to increase patient referrals and adoption, highlighting the need for more trained interventional radiologists.
- Performing prostatic artery embolization (PAE) in the Office-Based Lab (OBL) setting provides several advantages, including faster workflow, dedicated staff for pre- and post-procedure care, and streamlined imaging using a portable gamma camera.
Deep dives
PAE and the OBL: Advantages and Considerations
The introduction of prostatic artery embolization (PAE) in the American Urological Association guidelines has sparked excitement. PAE is increasingly viewed as a feasible alternative to surgical therapies, and its inclusion in the guidelines reflects its growing recognition. The guidelines emphasize the importance of collaboration between urologists and interventional radiologists, highlighting the need for specialized interventional radiologists with expertise in PAE. Many patients are self-referred, with a significant number seeking PAE after extensive research and not being informed about it by their urologist. The guidelines are expected to lead to increased awareness and adoption of PAE, benefitting patients who prefer minimally invasive options. PAE offers advantages such as preservation of sexual function, out-patient procedures, and low risk profiles for suitable candidates. Insurance coverage and appeals are expected to improve, removing the perception that PAE is experimental. The guidelines may also impact primary care physicians who manage the silent sufferers - men who avoid urologists due to fear of invasive treatments. PAE being included in the guidelines will likely prompt more primary care physicians to consider it as a non-invasive treatment option for lower urinary tract symptoms caused by BPH. Overall, the guidelines provide a boost to PAE and have the potential to increase patient access and improve outcomes.
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