Prostatic artery embolization (PAE) is a minimally invasive procedure for the management of benign prostatic hyperplasia (BPH), a common cause of lower urinary tract symptoms (LUTS) in older men. Since the Society of Interventional Radiology (SIR) 2019 Multisociety Consensus Position Statement on PAE, there has been rapid growth in clinical evidence, technological innovations, and increased acceptance of PAE as an alternative to transurethral resection of the prostate and other conventional surgical treatments. Notably, PAE has gained a place in multiple guidelines, including the American Urological Association's most recent guidelines, as a viable option for managing BPH-related LUTS. This practice guidance document synthesizes new clinical data and aims to provide updated guidance on patient selection, procedural technique, periprocedural care, outcome measures, safety, and future research directions. This document was developed by an SIR-appointed writing group of interventional radiologists and researchers with specialized expertise in PAE. The group analyzed published data up to 2025, referencing prior SIR guidelines and other relevant international standards. A wide array of literature, including randomized controlled trials, meta-analyses, retrospective studies, and expert opinions, was used to form this updated guidance.
Journal of vascular and interventional radiology : JVIR. 2026 Jun 01 [Epub ahead of print]
Samdeep Mouli, Bart L Dolmatch, Andrew J Gunn, Riad Salem, Justin P McWilliams, Timothy D McClure, Tiago A Bilhim, Shivank S Bhatia, Francisco Cesar Carnevale, Ziv J Haskal, Andre Uflacker, Luke R Wilkins
Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Memorial Hospital, Chicago, Illinois. Electronic address: ., Interventional Radiology, Sutter Health, Mountain View, California., Radiology Department, University of Kentucky, Lexington, Kentucky., Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Memorial Hospital, Chicago, Illinois., Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California., Radiology and Urology, Weill Cornell Medicine, New York, New York., Central University Hospital of Lisbon, Lisbon, Portugal., Department of Interventional Radiology and Urology, University of Miami, Coral Gables, Florida., Interventional Radiology, University of São Paulo, São Paulo, Brazil., Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia., Lowcountry Urology Clinics, Charleston, South Carolina; Savannah Vascular Institute, Savannah, Georgia., University of Virginia School of Medicine, Charlottesville, Virginia.