Prostatic arterial supply: demonstration by multirow detector angio CT and catheter angiography

Area of Science:

• Vascular anatomy
• Interventional radiology
• Medical imaging

Background:

• Prostatic arterial supply is complex and variable.
• Accurate anatomical knowledge is crucial for successful prostatic arterial embolisation.
• Multidetector Angio CT and Digital Subtraction Angiography (DSA) are advanced imaging techniques.

Purpose of the Study:

• To evaluate the prostatic arterial supply using multidetector Angio CT and DSA.
• To classify prostatic arteries based on origin, direction, pedicles, termination, and anastomoses.
• To assess the utility of Angio CT as a pre-intervention tool.

Main Methods:

• Digital Subtraction Angiography (DSA) performed in 21 patients, with 7 also undergoing Pelvic Angio CT.
• Pelvic Angio CT performed in an additional 4 patients.
• Classification of prostatic arteries in 50 pelvic sides based on origin, direction, number of pedicles, termination, and anastomoses.

Main Results:

• The internal pudendal artery was the most frequent origin (56%), followed by the common gluteal-pudendal trunk (28%).
• Less common origins included the obturator artery (12%) and inferior gluteal artery (4%).
• Two separate vascular pedicles were observed in 24% of cases, with various anastomoses noted with surrounding arteries.

Conclusions:

• Precise definition of prostatic artery origin and direction is essential for selective catheterisation.
• Angio CT is a valuable pre-intervention tool for planning procedures.
• The number of vascular pedicles and presence of anastomoses must be considered during prostatic arterial embolisation planning.