Prostatic arterial supply: demonstration by multirow detector Angio CT and Catheter Angiography
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To evaluate the prostatic arterial supply with multidetector Angio CT and Digital Subtraction Angiography (DSA).
DSA was performed in 21 male patients (7 of these also underwent Pelvic Angio CT); a further 4 patients only underwent Angio CT. Prostatic arteries were classified according to their origin, direction, number of pedicles, termination and anastomoses with surrounding arteries in 50 pelvic sides.
The most frequent origin was the internal pudendal artery (n = 28; 56%) with the common gluteal-pudendal trunk the next commonest (n = 14; 28%). Less frequent origins were the obturator artery (n = 6; 12%) or the inferior gluteal artery (n = 2; 4%). Two separate vascular pedicles were found in 12 pelvic sides (24%). There were anastomoses with the termination of the internal pudendal artery in 24% of cases (n = 12), with the contra-lateral prostatic arteries in 6 cases (12%), and to the superior vesical artery in 4 cases (8%).
Defining prostatic artery origin and direction is paramount to allow selective catheterisation. Angio CT is very useful as a pre-intervention tool. The number of independent vascular pedicles and the presence of anastomoses with surrounding arteries should be taken into account when planning prostatic arterial embolisation.
KeywordsProstatic artery Anatomy Prostatic arterial vascularisation Angio CT Catheter Angiography
The corresponding authors confirm that they have full access to all the data in this study and have final responsibility for the decision to submit for publication.
There are no conflicts of interest for any of the authors and institutions and no financial or personal relationships with other people or organisations that could inappropriately influence (bias) this work.
João E. G. O’Neill, MD PhD receives support from Fundação para a Ciência e Tecnologia (FCT).
All authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Sandra Carmo for the precious help and support in defining the best tube angulations for DSA and PAE. Teresa Calças, Iládia and Maria José for their support in many PAE procedures.
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