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Abstract No. 77: Relevant angiographic findings during prostatic arterial embolization for the treatment of benign prostatic hyperplasia
Abstract   Open access   Peer reviewed

Abstract No. 77: Relevant angiographic findings during prostatic arterial embolization for the treatment of benign prostatic hyperplasia

J.M. Motta Leal Filho, F.C. Carnevale, A.A. Antunes, O.M. Gonçalves, R.H. Baroni, L.M. Cerri, A.Z. Marcelino, G.C. Freire, M. Srougi and G.G. Cerri
Journal of vascular and interventional radiology, Vol.23(3 Supplement), pp.S34-S34
03/2012
DOI: 10.1016/j.jvir.2011.12.116
url
https://doi.org/10.1016/j.jvir.2011.12.116View
Published (Version of record) Open Access

Abstract

Purpose The aim of this paper is to describe the angiographic aspects of prostate vascular anatomy, drawing attention to the potential technical difficulties and complications during prostatic arterial embolization for the treatment of benign prostatic hyperplasia. Materials and Methods This study had local ethical committee approval; all patients gave written informed consent. A prospective phase I/II study was undertaken between June 2008 and November 2010, 11 male patients, mean age 68.5 years-old (range, 59 to 78). All patients presented with acute urinary retention and bladder catheters due to benign prostatic hyperplasia refractory to medical treatment, with a clinical indication for transurethral prostatectomy and were submitted to prostatic arterial embolization. Angiographic and anatomic examinations were performed jointly by two interventional radiologists. Special attention was given to the origin, width, course, and branches of the inferior vesical artery and the prostatic branches. Anastomoses were searched for. Results Twelve angiographic studies were performed in 11 patients. A total of 22 pelvic halves were analyzed. Clinical success was achieved in 91% (10 of the 11 patients), with a mean prostate volume reduction of over 30% at 6 months follow-up. Throughout this study some features of the prostatic vascular anatomy were observed. The most frequent origin of the inferior vesical artery and its prostatic branches was as a third branch of the anterior trunk of the internal iliac artery (n = 10; 43.5%). The majority of patients presented a maximum diameter of the inferior vesical arteries (n = 21; 91.3%) of 2.5mm or less (average 2.15mm). Each inferior vesical artery emits from two to four prostatic arterial branches. Many anastomoses were identified among the inferior vesical artery and the surrounding arteries (n= 10; 43.5%). Conclusion There needs to be better knowledge of vascular prostatic anatomy in order to avoid serious complications during prostatic arterial embolizations for the treatment of benign prostatic hyperplasia, since these arteries have varying origins, reduced diameters, tortuosity and many anastomoses with other neighboring organs arteries.

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