Ep. 416 PAE in the OBL with Dr. Charles Nutting

In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Charles Nutting about prostatic artery embolization (PAE) in the outpatient-based lab (OBL) setting. Dr. Nutting is an interventional radiologist at Endovascular Consultants in Lone Tree, Colorado. The doctors discuss procedure techniques, patient selection, follow-up care, and benefits of the OBL environment over the hospital. Dr. Nutting emphasizes that it is important to learn PAE in a hospital setting before transitioning to the OBL. He recommends using consistent equipment to help with the learning process. Dr. Nutting also shares his experience with radiopaque beads in PAE and describes the advantages of seeing the deposition of the beads into the gland. The doctors discuss the potential impact of the 2023 American Urological Association (AUA) Guidelines, which for the first time recognizes PAE for the treatment of symptomatic benign prostatic hyperplasia (BPH), and what this might mean for patient volume and interventional radiology training. --- CHECK OUT OUR SPONSOR Varian, a Siemens Healthineers company https://www.varian.com/products/interventional-solutions/embolization-solutions --- SHOW NOTES 00:00 - Introduction 03:03 - Impact of New AUA Guidelines on PAE 04:48 - Benefits of PAE for Patients 06:37 - Role of Primary Care Physicians in PAE 08:18 - Practice of PAE in the OBL 19:08 - Role of Urodynamic Studies 22:23 - Challenges of Treating Small Glands 26:11 - Procedure Steps and Techniques 34:19 - Post-Procedure Care and Follow-up 38:33 - The Future of Prostate Embolization --- RESOURCES Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023: https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the UK-ROPE study): https://pubmed.ncbi.nlm.nih.gov/29645352/ NICE - Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia: https://www.nice.org.uk/guidance/ipg611 Yttrium-90 Radioembolization in the Office-Based Lab: https://pubmed.ncbi.nlm.nih.gov/32800662/ Role of Urodynamic Studies in Management of Benign Prostatic Obstruction: A Guide for Interventional Radiologists: https://www.jvir.org/article/S1051-0443(16)30520-6/fulltext International Prostate Symptom Score (IPSS): https://www.urologygroup.com/wp-content/uploads/2019/07/IPSS-Form-Before-Tx-_-BPH.pdf