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Updated: Mar 2, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Case-Control Study of Intra-arterial Verapamil for Intraprostatic Anastomoses to Extraprostatic Arteries in Prostatic
Simon Chun Ho Yu1, Carmen Cho1, Esther Hung1
1Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, c/o Rm. 2A061, 2/F, Main Clinical Block and Trauma Centre, 30-32 Ngan Shing St., Shatin, New Territories, Hong Kong SAR; Vascular and Interventional Radiology Foundation Clinical Science Center, Prince of Wales Hospital, The Chinese University of Hong Kong, c/o Rm. 2A061, 2/F, Main Clinical Block and Trauma Centre, 30-32 Ngan Shing St., Shatin, New Territories, Hong Kong SAR.
Purpose:
It is hypothesized that intra-arterial administration of verapamil is a safe and effective way to reverse the flow in intraprostatic anastomoses to extraprostatic arteries without compromising treatment outcomes in prostatic artery embolization (PAE) for benign prostatic hypertrophy (BPH).
Materials And Methods:
A prospective study of 62 prostate sides in 31 consecutive patients (median age, 66 y; range, 60-71 y) with symptomatic BPH was undertaken. Median prostate volume was 72.4 mL (range, 48.8-85.8 mL), median International Prostate Symptom Score was 21 (range, 15-23), and median urine peak flow rate was 4 mL/s (range, 2-6 mL/s). The arterial anastomoses were classified as types I-III according to vascular morphology. Treatment safety was assessed in terms of adverse events and complications, and treatment effectiveness was assessed in terms of success rate of angiographic flow reversal.
Results:
The PAE procedure was successfully completed in all 31 patients (100%). Adverse events in both groups were transient and mild and did not necessitate prolonged hospitalization. There was no clinical evidence of any significant nontarget ischemic complication in either group. Intraprostatic anastomosis was diagnosed in 19 of 31 patients (61.3%) and 22 of 62 prostate sides (35.5%). Success rates of verapamil treatment were 88.9% overall (20 of 22) and 100% (19 of 19) in type II and III anastomoses. There was no difference between the treatment group and the control group in clinical, urologic, and imaging outcomes of PAE.
Conclusions:
Intra-arterial verapamil treatment was probably safe and effective in causing flow reversal in type II and III intraprostatic anastomoses and in preventing ischemic complications in PAE for BPH without compromising PAE outcomes.
