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