Development of prostatic arterial embolization (PAE) to treat benign prostatic hyperplasia (BPH) has raised interest in the variations of the PA. The aim of this study is to identify these vascular variations, to compare them with previous data, and to propose a simple classification.
Ten adult male pelvis sides from embalmed cadavers were dissected, ages 69 to 92 years, and 10 PA were examined. In a retrospective analysis of 34 DSA pelvic angiographies on 28 patients aged 50 to 90 years, 48 PA were identified. A total of 58 PA were therefore analyzed.
Six types are defined. Type I: PA originates from the anterior division (AD) of the internal iliac artery (IIA), 20.7%; type II: PA emerges from the obturator artery (OA), 5.2%; type III: PA arises from the gluteal-pudendal trunk (GPT), 27.5%; type IV: PA originates from the internal pudendal artery (IPA), 29.3%; type V: PA comes from the middle rectal artery (MRA), 15.5%. Other origins, not observed in our sample but described in the literature, were amalgamated under type VI.
The AD/GPT/IPA stem is the main source of the PA. Analysis of the definitions of IIA branches and the associated terminology is necessary for interpreting the results reported by several authors on different samples, but in general the results fit the meta-analysis well. A new, simple, and complete classification for vascular variations of the PA is proposed. This article is protected by copyright. All rights reserved.
Clinical anatomy (New York, N.Y.). 2016 Jul 14 [Epub ahead of print]
Celia Moya, Julián Cuesta, Alfonsina Friera, Jose María Gil-Vernet Sedó, Francisco J Valderrama-Canales
Department of Human Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain., Vascular and Interventional Radiology Unit, Radiology Service, Hospital Universitario de la Princesa, Madrid, Spain., Vascular and Interventional Radiology Unit, Radiology Service, Hospital Universitario de la Princesa, Madrid, Spain., Teknon Medical Centre, Urology Service, Barcelona, Spain., Department of Human Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.