Phase II Investigation of Prostate Artery Embolization (PAE) Before Radical Prostatectomy in Prostate Cancer Patients

Inclusion Criteria:

Patient is 45-79 years old
Patient has signed informed consent
Patient has biopsy-proven prostate adenocarcinoma with localized disease
Patient is a candidate for robot-assisted laparoscopic radical prostatectomy (RALRP)
Patient has a prostate size >40 grams

Exclusion Criteria:

Active urinary tract infection
History of life threatening allergy to iodinated contrast agents
Any known condition that limits catheter-based intervention or is a contraindication to embolization (eg shunt or adverse arterial anatomy)
Patient is unable to undergo MRI imaging
Cardiac condition including congestive heart failure or uncontrolled arrhythmia, uncontrolled diabetes mellitus, significant respiratory disease, or known immunosuppression which required hospitalization within the previous 6 months
Baseline serum creatinine level > 1.8 mg/dL
Baseline hemoglobin < 8.0 g/dL
Active cystolithiasis or prostatitis
History of pelvic irradiation or radical pelvic surgery
Known major iliac arterial occlusive disease
Confirmed or suspected bladder cancer
Urethral strictures, bladder neck contracture, or other bladder or urethral pathology that could limit catheterization
Previous rectal surgery (other than hemorrhoidectomy) or history of rectal disease if the therapy or patient evaluation may potentially cause injury to sites of previous rectal surgery, e.g. if a transrectal probe is used
Previous pelvic irradiation or radical pelvic surgery
Previous prostate surgery, balloon dilatation, stent implantation, laser prostatectomy, hyperthermia, or any other invasive treatment to the prostate
Prior transurethral resection of the prostate or other invasive therapies
Coagulation disturbances not normalized by medical treatment
Acute urinary retention
Hypersensitivity to gelatin products
Any contraindication to embolization, including intolerance to vessel occlusion procedures, vascular anatomy/blood flow that precludes catheter placement or embolic agent injection, presence/likely onset of vasospasm, presence/likely onset of hemorrhage, severe atheromatous disease, feeding arteries smaller than distal branches, arteriovenous shunt, and collateral vessel pathways endangering normal territories during embolization or pelvic inflammatory disease