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CardioVascular and Interventional Radiology

, Volume 38, Issue 4, pp 855–861 | Cite as

Pelvic Arterial Anatomy Relevant to Prostatic Artery Embolisation and Proposal for Angiographic Classification

  • André Moreira de AssisEmail author
  • Airton Mota Moreira
  • Vanessa Cristina de Paula Rodrigues
  • Sardis Honoria Harward
  • Alberto Azoubel Antunes
  • Miguel Srougi
  • Francisco Cesar Carnevale
Clinical Investigation

Abstract

Purpose

To describe and categorize the angiographic findings regarding prostatic vascularization, propose an anatomic classification, and discuss its implications for the PAE procedure.

Methods

Angiographic findings from 143 PAE procedures were reviewed retrospectively, and the origin of the inferior vesical artery (IVA) was classified into five subtypes as follows: type I: IVA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery (SVA); type II: IVA originating from the anterior division of the IIA, inferior to the SVA origin; type III: IVA originating from the obturator artery; type IV: IVA originating from the internal pudendal artery; and type V: less common origins of the IVA. Incidences were calculated by percentage.

Results

Two hundred eighty-six pelvic sides (n = 286) were analyzed, and 267 (93.3 %) were classified into I–IV types. Among them, the most common origin was type IV (n = 89, 31.1 %), followed by type I (n = 82, 28.7 %), type III (n = 54, 18.9 %), and type II (n = 42, 14.7 %). Type V anatomy was seen in 16 cases (5.6 %). Double vascularization, defined as two independent prostatic branches in one pelvic side, was seen in 23 cases (8.0 %).

Conclusions

Despite the large number of possible anatomical variations of male pelvis, four main patterns corresponded to almost 95 % of the cases. Evaluation of anatomy in a systematic fashion, following a standard classification, will make PAE a faster, safer, and more effective procedure.

Keywords

Benign prostatic hyperplasia (BPH) Prostatic artery embolisation (PAE) Pelvic anatomy 

Notes

Conflict of interest

All authors declare that they have no conflicts of interest.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2015

Authors and Affiliations

  • André Moreira de Assis
    • 1
    Email author
  • Airton Mota Moreira
    • 1
  • Vanessa Cristina de Paula Rodrigues
    • 1
  • Sardis Honoria Harward
    • 3
  • Alberto Azoubel Antunes
    • 2
  • Miguel Srougi
    • 2
  • Francisco Cesar Carnevale
    • 1
  1. 1.Interventional Radiology and Endovascular Surgery Department, Radiology InstituteUniversity of Sao Paulo Medical SchoolSão PauloBrazil
  2. 2.Urology DepartmentUniversity of Sao Paulo Medical SchoolSão PauloBrazil
  3. 3.The Dartmouth Center for Health Care Delivery ScienceHanoverUSA

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