Are balloon occlusion microcatheters your new best friend for prostate artery embolization (PAE)? In this episode of BackTable, Dr. Raj Ayyagari, interventional radiologist at Boston Medical Center, joins Dr. Ally Baheti to tackle complex clinical and technical challenges in PAE.

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This podcast is supported by an educational grant from Guerbet.

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SYNPOSIS

Dr. Ayyagari shares his unique journey from urology to interventional radiology and his experience building successful PAE service lines at multiple institutions. He walks through a series of challenging cases involving intraprostatic penile arteries, perivesicular collaterals, and internal pudendal collaterals used to treat bilateral hemi-prostates. The discussion highlights the role of balloon occlusion microcatheters such as the Sniper, his transition from 100–300 micron particles to glue embolization, and scenarios where coil protection is essential to prevent nontarget embolization. He also covers post-procedural management, the importance of setting expectations around suprapubic tube removal, and why thorough patient and provider counseling is critical for optimal care.

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TIMESTAMPS

00:00 - Introduction
02:14 - Building a Practice in Prostate Artery Embolization
08:19 - Case Studies and Techniques in Prostate Artery Embolization
23:16 - Challenges in Embolization Techniques
23:47 - Step-by-Step Guide to Embolizing a Hemi Prostate
25:24 - Choosing the Right Beads for Embolization
29:10 - Transitioning to Liquid Embolics
35:38 - Setting Patient Expectations and Pre-Procedure Evaluation
40:17 - Post-Procedure Care and Medications
44:06 - Conclusion and Final Thoughts