Virginia Interventional and Vascular Associates Continues to Bring World-Renowned Expertise to Our Local Region

In Elias, Newsletter, Volume 12 Issue 1 by Addison Clark

In collaboration with Mary Washington Healthcare, Virginia Interventional and Vascular Associates (VIVA) added Prostate Artery Embolization (PAE) to its list of outpatient offerings in August of 2018. Board Certified, Fellowship Trained Interventional Radiologist, Dr. Gustavo Elias, conducted the very first PAE procedure in the Fredericksburg region with great success.

“I felt very compelled to bring this procedure to the area,” said Dr. Elias. “Since one-third of all men aged 40-80 develop an enlarged prostate, PAE offers a new, minimally invasive treatment for improving the symptoms of benign prostatic hypertrophy (BPH) without the higher risk of complications that can be associated with surgery.” Dr. Elias trained at Yale-New Haven Hospital under the tutelage of Dr. Raj Ayyagari. During his time there, Yale-New Haven performed the largest number of PAE procedures in New England. Dr. Elias now brings this world-renowned expertise to the local region.

The effect of BPH on patients’ lives is staggering. Dr. Elias stated, “the symptoms of BPH, including frequent or urgent need to urinate, inability to empty the bladder, and frequent urination at night, have caused an estimated 38 billion collective hours of lost productivity and negative impact on quality of life for those suffering from the condition.”

What is Prostate Artery Embolization?

Prostate artery embolization (PAE) is a minimally invasive procedure for the treatment of benign prostatic hypertrophy, commonly referred to as BPH. The procedure is performed as an alternative to transurethral resection of the prostate (TURP). TURP is the current surgical standard of treatment but is also associated with a higher risk of complications such as incontinence, bleeding, retrograde ejaculation into bladder, and hospitalization.

The outpatient, minimally invasive PAE procedure shrinks the prostate by treating the blood vessels leading to the organ.Through a pinhole incision in either the wrist or upper thigh, tiny microscopic beads are injected under x-ray guidance into the right and left prostatic arteries. By obstructing the prostatic arteries and blocking the blood flow, the result is gland ischemia and a subsequent reduction of the size of the prostate. The procedure aims to alleviate the symptoms of BPH, including a weak urine stream, frequent trips to the bathroom to urinate, urinating often at night, and difficulty starting a urine stream.

Preparation may include:

● Imaging study of the arteries and prostate gland
● Evaluation of urine flow
● Blood test

Who is a candidate for PAE?

PAE may be the ideal procedure for patients who:

● Are not candidates for surgical resection
● Want to avoid general anesthesia
● Prefer not to have an invasive procedure

PAE is currently not recommended for patients who:

● Have prostate cancer
● Have arteries that will not accommodate the procedure

To learn more about procedures provided at VIVA, please speak with your primary care physician or go to