Advice please - which option should I choose?

I don't know what to tell u.

Have you asked your urologist about whether it might be possible to determine where in the prostate the bleeding is happening? It would seem as though that is possible if the PAE procedure was accurately done to eliminate bleeding for a couple of years.

My first thought when I read your post is to try the Rezum procedure because I've had it done and it was, at least for me, a simple procedure. It also has very ittle chance of RE or ED. The steam from the Rezum device may be able to, if accurately administered, kill off the area of the prostate where the bleeding is occurring. 

You have a hard choice.  I do not think you should have any procedure.  You do not know if it is going to work or not and any procedure you have comes with it's own list of side effects.  Anything that cut the prostate will cause retro ejaculation It may also cause you erection problems, leaking where you will have to wear a pad all the time.  I think you should leave well enough alone.  If it is only a little blood I would not worry about it.  I read a article about a guy had a little blood in his sperm after sex and it did not hurt his wife.  She ended up having a baby.  I do not think it will harm your partner Or you just ware a condom and be able to have sex  It is up to you.  Ken 

Embolization can be used for bleeding so I can see how the PAE helped for awhile.  I would assume after two PAEs your prostate is shrunk down considerably.  I would look at any meds or supplements that may contribute to thinning of the blood,  I'm wondering if there is a vascular specialist (they do exist) that may be helpful.  Whether their specialty extends into prostate bleeding issues, I don't know.  There is a Society for Vascular Surgery.

Have you had an MRI scan to give your urologist / vascular surgeon (VS) a picture of where problem may be.  My VS told me on Monday that the initial slight blood colouring of seminal fluid which I reported was a new one on him though the "literature" acknowledged it could occur.  It soon stopped (op was 2 months ago); I had wondered whether during the 2 hours of the op one of the small tubes finding their way along my arteries might have damaged something.  I am happy now it has not.  If your bleeding continues and is heavy, I feel further investigation is needed

I had same symptoms as you. Literally peeing blood and very large clots. At least you got an answer from your doctor. After a couple of ct scans and a cystoscopy I was told I needed TURP. I was never told about the friable vascularized prostate condition you have. I did not have TURP. I  went on finasteride. After 1 year of on and off bleeding it stopped. I'm guessing the finasteride shrunk my prostate enough to distroy the area that was bleeding. Its been almost 2 years since the last time I peed blood.

I wish I could help you. Doctors won't give you the full picture. I turned down the urolift and will try flowmax.