Gregory Amouyal1,2, Olivier Pellerin3,4,5, Costantino Del Giudice3,4, Carole Dean4,5, Nicolas Thiounn3,6, Marc Sapoval3,4,5. 1. Faculté de Médecine, Université Paris Descartes - Sorbonne - Paris - Cité, Paris, France. gregamouyal@hotmail.com. 2. Interventional Radiology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015, Paris, France. gregamouyal@hotmail.com. 3. Faculté de Médecine, Université Paris Descartes - Sorbonne - Paris - Cité, Paris, France. 4. Interventional Radiology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015, Paris, France. 5. INSERM U970, Paris, France. 6. Urology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015, Paris, France.
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.
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.
Authors: Bruna Ferreira Pilan; André Moreira de Assis; Airton Mota Moreira; Vanessa Cristina de Paula Rodrigues; Francisco Cesar Carnevale Journal: Radiol Bras Date: 2022 Jan-Feb
Authors: Gregory Amouyal; Louis Tournier; Constance De Margerie-Mellon; Atanas Pachev; Jessica Assouline; Damien Bouda; Cédric De Bazelaire; Florent Marques; Solenne Le Strat; François Desgrandchamps; Eric De Kerviler Journal: J Pers Med Date: 2022-07-31