Background and Aim Prostatic artery embolization (PAE) is a minimal invasive effective method in the treatment of benign prostatic hyperplasia (BPH). The procedure is technically challenging as pelvic vascular anatomy is highly prone to variations and identification of the prostatic artery (PA) is the most time consuming step which can lead to increased procedure times. The aim of our study is to categorize the anatomic variations in the prostatic supply in patients with BPH treated with PAE. Materials and Method Digital subtraction angiography findings of 68 PAE procedures were reviewed retrospectively and patients? age, PA origin, number and PT were recorded. The origin of the PA was classified into five subtypes using De Assis/Carnavale classification. The incidence of each anatomic type was calculated. Results In 68 PAE procedures 119 pelvic sides were analyzed and a total of 119 PAs were classified. The most common origin was type 1 (n = 43, 36.1%), PA originating from the anterior division of the IIA, from a common trunk with the superior vesical artery. This was followed by type 4 (n = 34, 28.6%), PA originating from the internal pudendal artery; type 3 (n = 22, 18.5%), PA originating from the obturator artery; type 2 (n = 13, 10.9%), PA originating from the anterior division of the IIA. Conclusion Anatomic variations are common in internal iliac artery and prostatic artery showing racial and individual differences. Following a standard classification system to identify the origin of the PA is crucial and being aware of the most common types in your population will make PAE a faster and safer procedure.
Turk J Med Sci (Turkish journal of medical sciences)
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