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CardioVascular and Interventional Radiology

, Volume 40, Issue 9, pp 1321–1337 | Cite as

Anatomical Variants in Prostate Artery Embolization: A Pictorial Essay

  • Francisco Cesar CarnevaleEmail author
  • Guilherme Rebello Soares
  • Andre Moreira de Assis
  • Airton Mota Moreira
  • Sardis Honoria Harward
  • Giovanni Guido Cerri
Review

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.

Keywords

Prostatic artery embolization Benign prostatic hyperplasia Lower urinary tract symptoms Arterial Vascular Anatomy 

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

Notes

Compliance with Ethical Standards

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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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Francisco Cesar Carnevale
    • 1
    Email author
  • Guilherme Rebello Soares
    • 1
  • Andre Moreira de Assis
    • 1
  • Airton Mota Moreira
    • 1
  • Sardis Honoria Harward
    • 2
  • Giovanni Guido Cerri
    • 1
  1. 1.Department of RadiologyUniversity of Sao PauloSao PauloBrazil
  2. 2.The Dartmouth Institute for Health Policy and Clinical PracticeLebanonUSA

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