Urology and IR Is PAE a case study for developing cross-specialization treatments?


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nterventional radiologist Ari J. Isaacson, MD, and urologist Matthew C. Raynor, MD, who work together at UNC Health, have collaborated on


a program that offers prostate artery embolization (PAE) to treat benign prostatic hyperplasia (BPH). In this partnership profile, IR Quarterly spoke with Drs. Isaacson and Raynor about their program, its challenges and the benefits it holds to patients.


How did the PAE collaboration between IR and urology begin? Ari J. Isaacson, MD: When it began, PAE was entirely research. The therapy was very early in the development


process, and I was interested in working in a burgeoning field. It was important to me that we approached the study from a collegial perspective. Of all the urologists, I knew Matt the best because I’d trained at UNC and knew him as an attending and a nice guy. I knew Matt would be reasonable and interested, so


12 IRQ | WINTER 2022 SUPPLEMENT


I said, “This is just research, but we want to evaluate the efficacy of PAE. Would you be willing to be a co-investigator?”


Matthew C. Raynor, MD: From my point of view, urology and IR are natural collaborators. There are many areas urology works


in which overlap with IR: percutaneous access to kidneys, stone treatments, management of small kidney tumors with ablation, angio and embolization for kidneys, and angiomyolipoma. Because there is a lot of overlap, there is a natural base for collaboration. Our PAE program stems from that. Our collaboration allowed us to evaluate PAE patients the way we wanted and enabled us to offer different options and build up PAE. It has really exploded since then and has been quite successful.


AI: Once our study demonstrated that PAE was safe and efficacious, we transitioned it to clinical practice. I spoke at urology grand rounds a few times to


give our results, and I think approaching it like that from the beginning—starting with research and asking for buy in, instead of just coming in and saying it worked and asking for patients—was the right way to go.


It sounds like the UNC urology department was very supportive. Is the rest of the specialty generally supportive as well? MR: Back then, the answer would have been “no.” Every urologist I knew of, even at UNC, was not a fan of PAE. But being at an academic center, we’re open to trying new things and we’re all about testing hypotheses and seeing what works and what doesn’t. This is a new technology that was going to happen regardless of whether urology was involved or not, so I wanted to get involved in some good trials and studies that would determine if it is effective and where it fits in the armamentarium of treating BPH. We now know that the technology works, and many urologists are starting to incorporate PAE into


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