The next ESIR course focussing on PAE will take place July 4-5 in Harlow, UK. Local host Dr. Zaid Aldin of the Princess Alexandra Hospital spoke to us to tell us about his experience performing PAE, his multidisciplinary approach to the course, and the key skills needed to perform successful PAE procedures.
CIRSE: What inspired you to want to create a course on PAE? Can you describe what your current practice looks like?
Aldin: I have a passion for training, education, and sharing knowledge; I’m delighted to host this European School of Interventional Radiology course on PAE. In our hospital, the Princess Alexandra Hospital in Essex, we have a modern learning centre which is well-equipped to host advanced courses. At the moment, we do about one to two PAE cases every week. There’s a demand to do more cases as the medical community and the public become more aware of the benefits of this procedure in comparison to other treatment modalities.
CIRSE: Within the realm of PAE, what are some common challenges that practitioners often face and what are the key techniques and skills that are essential for IR’s engaging in PAE?
Aldin: Our first challenge is usually to convince urologists to work with us collaboratively and educate them about the benefits of PAE in order to get referrals and maintain a strong working relationship with them. This is a really important step. We should start by asking them to refer cases to us that they themselves are not keen to perform, such as cases where a patient is unfit for surgery or is on anticoagulation therapy.
Another challenge is to learn and have in-depth knowledge of the complex vascular anatomy of the prostatic arteries and also learn the fine microcatheter skills required to navigate these arteries. Also, we need to have a good understanding of the techniques, especially techniques to reduce the radiation dose to both our patients and our staff. I believe interventional radiologists performing PAE should function as clinicians, possessing knowledge of both the clinical aspects and techniques of PAE. One of the aims of this course is to focus on the clinical aspects, complementing technical skills with comprehensive clinical understanding.
CIRSE: What distinguishes this latest iteration of the PAE course from the previous couses that we have offered?
Aldin: In this course, we will focus on the latest evidence for prostatic artery embolization (PAE), including its recent inclusion in the American Urological Association guidelines as of September 2023. We will present recorded cases that demonstrate how to perform PAE in various clinical and anatomical scenarios, providing step-by-step guidance on performing radial PAE, a technique particularly useful for patients with tortuous iliac anatomy. Additionally, we will showcase a case with practical tips on using glue embolization, which has not been covered in previous courses.
Our fantastic collection of cases for simulator training will be supervised by our experienced faculty. The course incorporates the latest updates on the evidence for PAE and addresses all challenging PAE cases, ensuring participants are equipped with the most current knowledge and skills
CIRSE: How will this course enhance attendees’ practice and patient care outcomes?
Aldin: Participants will leave the course with practical knowledge on patient triage, selection, and the technical aspects of PAE, including considerations for repeat procedures, which is a new and big thing now. They will learn when to repeat PAE and when to refer patients to surgeons. The course will also cover new embolic agents, such as glue, and strategies to address urologists’ current arguments against prostatic artery embolization.
CIRSE: What are some of these arguments against PAE?
Aldin: One of the arguments against PAE is the lack of long-term data. We are currently in the process of collecting this data, and expect to have more comprehensive long-term results within the next three to five years. Another concern is the recurrence rate of symptoms after PAE; about 20% of patients may experience symptom recurrence within five years. However, our argument is that these patients have the option to undergo the procedure again or choose surgical alternatives. It’s important to note that similar recurrence rates are observed with TURP, where patients may require a repeat procedure five to ten years after the initial treatment.
CIRSE: What are you most looking forward to for the course?
Aldin: I look forward to meeting all the participants and faculty! The support from ESIR has been very helpful. The course is scheduled for July, which is a wonderful time to visit the UK.
Join Dr. Aldin and other leading experts at the ESIR course on prostatic artery embolization July 4-5 at the Princess Alexandra Hospital in Essex, UK! Click on the links below to register, browse the programme, or explore all upcoming ESIR courses.
