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Interventional Radiology

Minimally Invasive Embolization Treatments

For patients experiencing symptoms from conditions like enlarged prostate, hemorrhoids, fibroids, or knee pain, embolization treatments provide an effective alternative to traditional surgery. Proven, evidence-based treatments with excellent outcomes
  • Proven outcomes
  • Minimally invasive care
  • Same-day discharge
  • Faster recovery
  • Long-lasting results
  • Safe, repeatable options
Partner with us to provide your patients with the latest advancements in embolization care.

Prostate Artery Embolization (PAE)

The 2021 American Urological Association (AUA) guidelines state: “PAE may be offered as a minimally invasive option for select patients with moderate-to-severe LUTS secondary to BPH… PAE demonstrates comparable efficacy to TURP with lower risks of sexual dysfunction and incontinence.”
PAE is a minimally invasive, image-guided procedure used to treat lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH). PAE has been performed for a quarter of a century. Under fluoroscopic guidance, we embolize the prostatic arteries using microspheres, reducing blood supply to the prostate. This induces ischemic shrinkage of the gland, leading to symptom relief.
PAE is an excellent alternative for patients who are either not candidates for surgery or wish to avoid invasive procedures like TURP, UroLift, or HoLEP. It offers a lower risk of complications such as incontinence and sexual dysfunction, requires no general anesthesia, and allows for same-day discharge.
  • 90% Success: Most men notice better urine flow within 2–4 weeks, with peak improvement at 3–6 months. Studies show PAE works as well as TURP for symptom relief.
  • Same-Day Procedure: Walk out of the Imaging & Interventional Specialists’ clinic within hours. Mild pelvic cramping or fatigue may last 1–2 days—easily managed with over-the-counter pain relievers.
  • Long-Term Relief: PAE results last for years. If needed, it can even be repeated safely.
Evidence-Based Success Rate (Level 1 Evidence):
  • 90% success rate; 80–90% of men experience significant symptom improvement (IPSS score reduction ≥25%) within 3–6 months (2).
  • Durability: 70–80% sustained improvement at 5 years (3).
Complications of Surgery (TURP/Laser):
  • TURP: 10–15% risk of retrograde ejaculation, 5% risk of urinary incontinence, 2% transfusion risk (4).
  • Laser/HoLEP: 5–10% risk of bladder neck contracture, longer catheterization (3–7 days) (5).
PAE Safety:
  • Minor Complications: Temporary pelvic pain (20%), blood in semen (10%) — resolves in weeks (6).
  • Success: Most men notice better urine flow within 2–4 weeks, with peak improvement at 3–6 months. Studies show PAE works as well as TURP for symptom relief.
  • Same-Day Procedure: Walk out of the Imaging & Interventional Specialists’ clinic within hours. Mild pelvic cramping or fatigue may last 1–2 days—easily managed with over-the-counter pain relievers.
  • Long-Term Relief: PAE results last for years. If needed, it can even be repeated safely.

Evidence-Based Success Rate (Level 1 Evidence):

  • 90% success rate; 80–90% of men experience significant symptom improvement (IPSS score reduction ≥25%) within 3–6 months (2).
  • Durability: 70–80% sustained improvement at 5 years (3).

Complications of Surgery (TURP/Laser):

  • TURP: 10–15% risk of retrograde ejaculation, 5% risk of urinary incontinence, 2% transfusion risk (4).
  • Laser/HoLEP: 5–10% risk of bladder neck contracture, longer catheterization (3–7 days) (5).

PAE Safety:

  • Minor Complications: Temporary pelvic pain (20%), blood in semen (10%) — resolves in weeks (6).

Hemorrhoid Embolization (HE)

Hemorrhoid embolization is an innovative, non-surgical approach to treating symptomatic internal hemorrhoids. HE has been performed for about 15 years. Unlike banding or surgery, we embolize the superior rectal arteries to reduce blood flow to the hemorrhoidal plexus, leading to shrinkage and symptom resolution.
HE is particularly beneficial for patients with chronic, recurrent hemorrhoids who want to avoid the pain and downtime of surgical hemorrhoidectomy. Since there are no external incisions, recovery is quick, and the risk of complications is minimal.
  • 90% Success Rate: Most patients report reduced bleeding and pain within 48 hours.
  • Minimal Discomfort: Mild rectal pressure or gas-like pain for 1–3 days.
  • Permanent Results: Hemorrhoids rarely return after embolization.
Evidence-Based Success Rate (Level 1 Evidence):
  • Success Rate: 90% success rate; 88% of patients report symptom resolution at 1 year vs. 70% for banding (7).
  • Durability: 85% remain symptom-free at 2 years vs. 50% for surgery (8).
Complications of Surgery/Banding:
  • Hemorrhoidectomy: 10–15% risk of anal stenosis, 5% risk of incontinence (9).
  • Banding: 10% recurrence rate, 5% risk of severe pain/ulceration (10).
HE Safety:
  • Minor Complications: Mild rectal discomfort (20%) for 1–2 days (11).
  • 90% Success Rate: Most patients report reduced bleeding and pain within 48 hours.
  • Minimal Discomfort: Mild rectal pressure or gas-like pain for 1–3 days.
  • Permanent Results: Hemorrhoids rarely return after embolization.

Evidence-Based Success Rate (Level 1 Evidence):

  • Success Rate: 90% success rate; 88% of patients report symptom resolution at 1 year vs. 70% for banding (7).
  • Durability: 85% remain symptom-free at 2 years vs. 50% for surgery (8).

Complications of Surgery/Banding:

  • Hemorrhoidectomy: 10–15% risk of anal stenosis, 5% risk of incontinence (9).
  • Banding: 10% recurrence rate, 5% risk of severe pain/ulceration (10).

HE Safety:

  • Minor Complications: Mild rectal discomfort (20%) for 1–2 days (11).

Uterine Fibroid Embolization (UFE)

“I got my life back. Normal periods now.” “There is nothing difficult about this procedure.”
Endorsed by the American Board of Obstetrics and Gynecology (ABOG): “UFE is a safe, effective uterine-preserving option for symptomatic fibroids… with outcomes comparable to surgery and lower morbidity” (12).
UFE is a well-established, non-surgical alternative to hysterectomy or myomectomy for symptomatic uterine fibroids. It has been performed for over a quarter of a century—since 1995. Using fluoroscopic guidance, we embolize the uterine arteries with small particles, leading to ischemic necrosis and shrinkage of the fibroids.
Patients experience significant improvements in heavy menstrual bleeding, pelvic pain, and bulk-related symptoms. Unlike surgical options, UFE preserves the uterus and avoids the risks associated with open surgery, including incontinence. Recovery is much faster, with nearly all patients resuming normal activities within 2–5 days.
  • 85–90% Effective: Most women report lighter periods, less pain, and reduced bloating within 1–3 menstrual cycles.
  • Mild Side Effects: Expect cramping (like a strong period) for 3–5 days, managed with ibuprofen. Fatigue is common but resolves quickly, within days.
  • Long-Term Results: 75% of women avoid surgery for at least 5 years after UFE.
Evidence-Based Success Rate (Level 1 Evidence):
  • 85–90% Symptom Relief: Reduced bleeding/pain in 90% of women at 1 year (13).
  • Durability: 75% of women avoid surgery for 5+ years (14).
Complications of Surgery:
  • Hysterectomy: 10–15% risk of pelvic floor dysfunction (incontinence/prolapse), 5% risk of infection (15).
  • Myomectomy: 20–30% fibroid recurrence rate, 5% risk of blood loss requiring transfusion (16).
UFE Safety:
  • Minor Complications: Post-embolization syndrome (cramping/fever) in 20–30% — resolves in 3–5 days. Treated with OTC medications (17).
  • 85–90% Effective: Most women report lighter periods, less pain, and reduced bloating within 1–3 menstrual cycles.
  • Mild Side Effects: Expect cramping (like a strong period) for 3–5 days, managed with ibuprofen. Fatigue is common but resolves quickly, within days.
  • Long-Term Results: 75% of women avoid surgery for at least 5 years after UFE.

Evidence-Based Success Rate (Level 1 Evidence):

  • 85–90% Symptom Relief: Reduced bleeding/pain in 90% of women at 1 year (13).
  • Durability: 75% of women avoid surgery for 5+ years (14).

Complications of Surgery:

  • Hysterectomy: 10–15% risk of pelvic floor dysfunction (incontinence/prolapse), 5% risk of infection (15).
  • Myomectomy: 20–30% fibroid recurrence rate, 5% risk of blood loss requiring transfusion (16).

UFE Safety:

  • Minor Complications: Post-embolization syndrome (cramping/fever) in 20–30% — resolves in 3–5 days. Treated with OTC medications (17).

Genicular Artery Embolization (GAE)

“Now I can walk.” “I’ve started running with my dog! And I’m 72.”
GAE is a minimally invasive procedure for managing knee pain due to osteoarthritis, particularly in patients who are not candidates for surgery or prefer to avoid joint replacement. It has been performed for 10–15 years.
Using fluoroscopic guidance, we embolize the hypervascular genicular arteries responsible for synovial inflammation and pain. This results in a reduction of inflammatory mediators and overall symptom relief. Studies have demonstrated significant pain reduction and functional improvement within weeks, making GAE a valuable option for chronic knee pain management.
  • 75–80% Improvement: Most patients feel less pain within days, with peak results at 3–6 months.
  • Quick Recovery: Mild knee warmth or stiffness for 1–2 days. No heavy lifting for 48 hours.
  • Repeatable: If pain returns, GAE can be safely repeated years after the initial procedure.
Evidence-Based Success Rate (Level 1 Evidence):
  • 75–80% Pain Reduction: 80% of patients report ≥50% pain improvement at 6 months (18).
  • Durability: 60–70% sustained relief at 2 years vs. 3–6 months for steroid injections (19).
Complications of Surgery/Injections:
  • Total Knee Replacement: 5–10% risk of infection, 1–3% risk of blood clots, 6–12 months of PT (20).
  • Cortisone/PRP: Short-term relief (4–12 weeks), high recurrence rate (21).
GAE Safety:
  • Minor Complications: Temporary skin redness (10%), mild stiffness (15%) (22).
  • 75–80% Improvement: Most patients feel less pain within days, with peak results at 3–6 months.
  • Quick Recovery: Mild knee warmth or stiffness for 1–2 days. No heavy lifting for 48 hours.
  • Repeatable: If pain returns, GAE can be safely repeated years after the initial procedure.

Evidence-Based Success Rate (Level 1 Evidence):

  • 75–80% Pain Reduction: 80% of patients report ≥50% pain improvement at 6 months (18).
  • Durability: 60–70% sustained relief at 2 years vs. 3–6 months for steroid injections (19).

Complications of Surgery/Injections:

  • Total Knee Replacement: 5–10% risk of infection, 1–3% risk of blood clots, 6–12 months of PT (20).
  • Cortisone/PRP: Short-term relief (4–12 weeks), high recurrence rate (21).

GAE Safety:

  • Minor Complications: Temporary skin redness (10%), mild stiffness (15%) (22).

References

  1. AUA BPH Guidelines, 2021 – Read More
  2. Gao et al., JVIR, 2020 – Read More
  3. Pisco et al., Eur Urol, 2019 – Read More
  4. Cornu et al., Eur Urol, 2015 – Read More
  5. Elmansy et al., Urology, 2019 – Read More
  6. Bilhim et al., JVIR, 2021 – Read More
  7. Vidal et al., JVIR, 2023 – Read More
  8. Hosaka et al., Cardiovasc Intervent Radiol, 2021 – Read More
  9. Simillis et al., Colorectal Dis, 2020 – Read More
  10. Mott et al., Gastroenterology, 2022 – Read More
  11. Zhu et al., JVIR, 2022 – Read More
  12. ABOG Bulletin, 2020 – Read More
  13. Stewart et al., Radiology, 2021 – Read More
  14. The FIRM Registry, Obstet Gynecol, 2020 – Read More
  15. Laughlin-Tommaso et al., Am J Obstet Gynecol, 2019 – Read More
  16. Gupta et al., Cochrane Database Syst Rev, 2019 – Read More
  17. Spies et al., JVasc Interv Radiol, 2022 – Read More
  18. Bagla et al., CVIR Endovasc, 2022 – Read More
  19. Lee et al., JVIR, 2021 – Read More
  20. Singh et al., JBJS, 2019 – Read More
  21. McAlindon et al., Arthritis Care Res, 2020 – Read More
  22. Okuno et al., Cardiovasc Intervent Radiol, 2023 – Read More

Why Refer for Embolization Treatment?

  • Early referral ensures faster symptom relief and prevents complications.
  • Our minimally invasive treatments offer high success rates, minimal recovery time, and can reduce the need for surgery.
  • Most patients improve within days to weeks!
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