PROARTE -PROstate ARTery to Reduce the Symptoms of Benign Prostatic Hyperplasia

Inclusion Criteria: * • Men ≥45 and ≤90 years presenting with benign prostatic hyperplasia with symptoms for at least 6 months that are refractory to medical management or in whom medications are contraindicated, not tolerated, or refused. * International Prostate Symptom Score (I-PSS) score 14 or greater. * Quality of Life (QoL) score ≥ 3 * Peak urinary flow (Qmax) less than or equal to 12 mL/s with void volume \>125mL. * Prostate volume greater than 30 cc as determined by ultrasound, MRI, or CT. * Personal risk \<40% based on the University of Texas San Antonio prostate cancer risk calculator or having a negative prostate biopsy for cancer within the last 24 months. * Able to provide written consent. * Not participating in any other investigational drug or device studies. Exclusion Criteria: * • History of biopsy-proven prostate cancer * Renal insufficiency (glomerular filtration rates (GFR) less than 40mL/min/1.73 m2 who are not already on dialysis) * Prior prostate surgery or intervention, including trans-urethral resection of the prostate, balloon dilation, stent implantation, laser prostatectomy, radiation, UroLift®, or hyperthermia * Other bladder or urethral pathology requiring therapy, either in the past or currently, including neurogenic bladder, sphincteric abnormalities, bladder cancer, or other causes of bladder atonia. * Other causes of urinary obstruction, such as strictures of urethra or ureters, not related to BPH * Current decompensated congestive heart failure, uncontrolled diabetes mellitus, significant respiratory disease, or known immunosuppression. * Neurological disease, including multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, and previous spinal nerve surgery * Patients with platelet count \<50,000/μL or International Normalized Ratio (INR) \>1.8, unless corrected for the procedure * Active urinary tract infection. Patients must have a negative culture within 7 days of the procedure. * Allergy to iodinated contrast agents unless pre-treated by corticosteroids. * Acute urinary retention. * Post void residual (PVR) \> 250 mL with urodynamic evidence of atonic bladder. Patients with a PVR \>250 but urodynamic testing consistent with obstruction will be allowed. * Bladder stone within three months prior to the procedure. * Hematuria not evaluated by Urologist for causes other than BPH. * Previous rectal surgery (excluding hemorrhoidectomy) or history of rectal disease. * Prior pelvic irradiation or radical pelvic surgery. Imaging exclusion criteria: • Internal iliac artery occlusion as determined by either CT or MRI.