What Is Prostatic Artery Embolization (PAE)?

Prostatic Artery Embolization (PAE) is a minimally invasive, image-guided procedure used to treat urinary symptoms caused by Benign Prostatic Hyperplasia (BPH), commonly known as an enlarged prostate. During PAE, tiny particles are injected into selected prostatic arteries to reduce blood flow to targeted area of the prostate. PAE is designed to reduce blood flow to the targeted areas. Over time, this reduction in blood supply causes the gland to gradually shrink, which can relieve pressure on the bladder and urethra and improve urinary symptoms.¹ 

This overview explains what PAE is, how it works, and where it fits within modern minimally invasive care. 

What is Benign Prostatic Hyperplasia (BPH)?

Benign Prostatic Hyperplasia (BPH) is a common condition in aging men where the prostate gland gradually enlarges.¹ As the prostate grows, it can compress the urethra and interfere with normal bladder function. This leads to lower urinary tract symptoms that often worsen over time and affect quality of life.¹ Common symptoms include frequent urination, urgent need to urinate, weak urine stream, difficulty starting urination, incomplete bladder emptying, nighttime urination (nocturia), and disrupted sleep due to urinary urgency. 

What is Prostatic Artery Embolization (PAE)?¹ 

PAE is a minimally invasive treatment performed by an interventional radiologist using real-time imaging guidance. The procedure begins with a small puncture in the wrist or groin to access the arterial system. A microcatheter is then navigated through blood vessels to the arteries supplying the prostate. Tiny embolic particles are delivered to reduce blood flow to target prostate tissue. This controlled reduction in blood supply leads to gradual shrinkage of the prostate. Most patients are observed for a short time after the procedure and return home the same day. 

Where does Robotic PAE fit as a treatment option? 

Robotic PAE is part of a broader shift in medicine toward image-guided, catheter-based treatments that avoid open surgery. These procedures require precise navigation through complex vascular anatomy using microcatheters and imaging guidance. As endovascular medicine evolves, technologies that support procedural navigation and control are increasingly being explored. One example is the LIBERTY® Endovascular Robotic System, designed to assist physicians in the navigation of endovascular instruments during catheter-based procedures. LIBERTY reflects the broader evolution of endovascular care, where robotics, imaging, and minimally invasive techniques converge to support physician-led procedures such as PAE, which require selective navigation of small pelvic arteries.

Ask your doctor if a LIBERTY-assisted procedure is right for you. 

How Does PAE Improve Symptoms?^1,2 

By reducing blood flow to enlarged prostate tissue, PAE decreases the size of the gland over time. As the prostate shrinks, pressure on the urethra is reduced. This can lead to improved urine flow and reduced urinary symptoms such as urgency, frequency, and nighttime urination. Symptom improvement typically develops gradually over several weeks. 

Benefits of Prostatic Artery Embolization^1,2 

• PAE is a minimally invasive treatment option for selected patients with BPH.
• It does not require surgical incisions or removal of prostate tissue.
• It is performed as an outpatient procedure, allowing most patients to go home the same day.
• Many patients experience improvement in urinary frequency, urgency, weak stream, and nocturia.
• Clinical experience has shown a favorable profile regarding preservation of sexual function compared with some surgical treatments.^1,2
• PAE may also be an option for patients who are not ideal surgical candidates, including those with medical comorbidities or those unable to discontinue anticoagulation therapy, as determined by a physician. 

Safety Profile and Side Effects¹ 

PAE has been evaluated in multiple clinical studies and professional society consensus statements. A multi-society consensus published in the Journal of Vascular and Interventional Radiology (JVIR) reported a complication rate of less than 0.5%. Most side effects are mild and temporary. These may include increased urinary frequency, mild pelvic discomfort, blood in urine or stool, and mild gastrointestinal symptoms. These effects are generally self-limited and resolved within days to a week. 

References

1. McWilliams J, Bilhim T, Carnevale F, et al. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia. Journal of Vascular and Interventional Radiology. 2019;30:627–637.e1.
2. Qamhawi Z, Little MW. The State of Evidence in Prostate Artery Embolization. Seminars in Interventional Radiology. 2022;39(6):571-576.

Important Safety Information

Not all patients are candidates for LIBERTY-assisted procedures. Patients should consult their physician to determine whether LIBERTY is appropriate for their condition.

As with any endovascular procedure, serious complications may occur, including but not limited to:

• Arterial injury
• Bleeding
• Conversion to other manual endovascular techniques can occur and could result in a longer operative time
• Additional procedure-related complications

LIBERTY is not indicated for coronary or neurovascular procedures.

Microbot Medical does not practice medicine. Only a licensed physician can evaluate symptoms, provide a diagnosis, and recommend treatment options. Patients should discuss with their physician whether a robotic endovascular procedure is appropriate for their care.