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CardioVascular and Interventional Radiology

, Volume 41, Issue 11, pp 1664–1673 | Cite as

Variants of Patterns of Intra- and Extra-prostatic Arterial Distribution of the Prostatic Artery Applied to Prostatic Artery Embolization: Proposal of a Classification

  • Gregory Amouyal
  • Olivier Pellerin
  • Costantino Del Giudice
  • Carole Dean
  • Nicolas Thiounn
  • Marc Sapoval
Clinical Investigation Arterial Interventions
  • 179 Downloads
Part of the following topical collections:
  1. Arterial Interventions

Abstract

The development of prostatic artery embolization has led to better understand the complex male pelvic arterial anatomy. To the best of our knowledge, there is still no precise description of the distribution of the branches of the prostatic artery (PA) after its origin. In this study, the patterns of prostatic feeders near to and into the prostate were analyzed, and a classification was proposed.

Materials and Methods

This study is based on angiograms of 101 consecutive male patients, mean age 70, who underwent PAE between December 2013 and June 2016, to treat symptomatic benign prostatic hyperplasia.

Results

The proposed classification is derived from the analysis of 143 solitary PAs from 199 hemipelves (72%). Pattern A was defined as an artery feeding only the prostate, patterns B and C as a PA with a concomitant large supply to the penis (pattern B) or to the rectum (pattern C). A pattern A was found in 89/143 (62%), a pattern B in 16/143 (12%) and pattern C in 38/143 (26%). Protection of a penile/rectal supply was never required in pattern A, while it was performed in 14/16 (87%) of pattern B, and in 7/38 (18%) of pattern C PAs. The PErFecTED technique could be performed in 51%, 50 and 55% of cases in pattern A to C.

Conclusion

This study proposes a new classification of intra-/extra-prostatic arterial distribution of the PA that could be helpful to prevent complications of PAE. Further prospective angiographic investigations are necessary to confirm its clinical value.

Keywords

Prostatic Hyperplasia Embolization Therapeutic Endovascular procedure Radiology Interventional Prostate 

Abbreviations

BPH

Benign prostatic hyperplasia

PA

Prostatic artery

PAE

Prostatic artery embolization

LUTS

Lower urinary tract symptoms

AUR

Acute urinary retention

IR

Interventional radiologist

IRB

Institutional review board

DSA

Digital subtraction angiography

AP

Antero-posterior

CBCT

Cone beam computed tomodensitometry

IIA

Internal iliac artery

PT

PErFecTED technique

APA

Accessory pudendal artery

IPA

Internal pudendal artery

Notes

Compliance with Ethical Standards

Conflict of interest

Authors Gregory Amouyal, Olivier Pellerin, Costantino Del Giudice, Carole Dean, Nicolas declare that they have no conflict of interest. Thiounn Marc Sapoval has financial support from Merit Medical (Salt Lake City, USA) for attending/speaking at symposia/congresses and for educational programs.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.”

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Faculté de MédecineUniversité Paris Descartes - Sorbonne - Paris - CitéParisFrance
  2. 2.Interventional Radiology Department, Assistance Publique - Hôpitaux de ParisHôpital Européen Georges PompidouParisFrance
  3. 3.INSERM U970ParisFrance
  4. 4.Urology Department, Assistance Publique - Hôpitaux de ParisHôpital Européen Georges PompidouParisFrance

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