Utilization of a steerable microcatheter and adjunctive techniques for prostatic artery embolization in anatomically...

Area of Science:

• Interventional Radiology
• Vascular Anatomy
• Urology

Background:

• Prostatic artery (PA) origin from a common trunk with the superior vesical artery (SVA) presents significant technical challenges during PA catheterization for PA embolization (PAE).
• These anatomical variations increase operative time, radiation exposure, costs, and the risk of technical failure in PAE procedures.

Purpose of the Study:

• To evaluate the efficacy of a steerable microcatheter (MC) and adjunctive techniques in improving technical success rates for PAE in cases with challenging vesicoprostatic arterial anatomy.
• To assess the impact of these methods on procedural complications and outcomes.

Main Methods:

• Retrospective analysis of PAE procedures utilizing a steerable MC, with and without adjunctive techniques.
• Adjunctive techniques included protective SVA embolization, embolization via collateral vessels, and proximal embolization near the PA orifice.
• Data collected on technical success, operative time, radiation dose, complications, and patient outcomes.

Main Results:

• The use of a steerable MC, with or without adjunctive techniques, resulted in a 35% increase in technically successful PA embolization for PAs originating from vesicoprostatic trunks.
• No significant complications were observed in patients treated with the steerable MC and adjunctive techniques.
• The study involved 12 patients treated with the steerable MC and adjunctive techniques, and 23 patients treated with the steerable MC alone.

Conclusions:

• Familiarization with and application of steerable microcatheters and adjunctive techniques can significantly enhance the technical success of PAE.
• These approaches are effective in managing challenging prostatic and superior vesical artery anatomy, leading to improved procedural outcomes.