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Anatomical Variants in Prostate Artery Embolization: A Pictorial Essay

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Abstract

Prostate artery embolization (PAE) has emerged as a new treatment option for patients with symptomatic benign prostatic hyperplasia. The main challenges related to this procedure are navigating arteries with atherosclerosis and anatomical variations, and the potential risk of non-target embolization to pelvic structures due to the presence of collateral shunts and reflux of microparticles. Knowledge of classical vascular anatomy and the most common variations is essential for safe embolization, good clinical practice, and optimal outcomes. The aim of this pictorial essay is to illustrate the pelvic vascular anatomy relevant to PAE in order to provide a practical guide that includes the most common anatomical variants as well as to discuss the technical details related to each.

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Abbreviations

PAE:

Prostate artery embolization

LUTS:

Lower urinary tract symptoms

BPH:

Benign prostatic hyperplasia

IIA:

Internal iliac artery

SVA:

Superior vesical artery

IVA:

Inferior vesical artery

MRI:

Magnetic resonance imaging

IPA:

Internal pudendal artery

aIPA:

Accessory internal pudendal artery

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Authors and Affiliations

  1. Department of Radiology, University of Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil

    Francisco Cesar Carnevale, Guilherme Rebello Soares, Andre Moreira de Assis, Airton Mota Moreira & Giovanni Guido Cerri

  2. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA

    Sardis Honoria Harward

Authors
  1. Francisco Cesar Carnevale
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  2. Guilherme Rebello Soares
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  3. Andre Moreira de Assis
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  4. Airton Mota Moreira
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  5. Sardis Honoria Harward
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  6. Giovanni Guido Cerri
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Corresponding author

Correspondence to Francisco Cesar Carnevale.

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Conflict of interest

Authors FCC and SHH are research consultants to Merit Medical Systems, Inc. FCC receives patent royalties from Merit Medical Systems that is not associated with this project.

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Carnevale, F.C., Soares, G.R., de Assis, A.M. et al. Anatomical Variants in Prostate Artery Embolization: A Pictorial Essay. Cardiovasc Intervent Radiol 40, 1321–1337 (2017). https://doi.org/10.1007/s00270-017-1687-0

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  • DOI: https://doi.org/10.1007/s00270-017-1687-0

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