Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Angiographic Anatomy of the Prostatic Artery in the Korean Population: A Bicentric Retrospective Study

  • Seunghyun Lee (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Dong Jae Shim (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Doyoung Kim (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Soo Buem Cho (Department of Radiology, College of Medicine, Ewha Womans University) ;
  • Seung Hwan Baek (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Edward Wolfgang Lee (Division of Interventional Radiology and Liver Transplant Surgery, Department of Radiology and Surgery, UCLA Medical Center, David Geffen School of Medicine at UCLA) ;
  • Jung Whee Lee (Department of Radiology, College of Medicine, The Catholic University of Korea)
  • Received : 2024.05.12
  • Accepted : 2024.08.19
  • Published : 2024.11.01
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Abstract

Objective: The aim of this study was to analyze the origins of prostatic arteries (PAs) in the Korean population and compare them with those reported in the literature. Materials and Methods: From April 2018 to February 2024, 108 male (mean age ± standard deviation: 71.6 ± 9.7 years) with lower urinary tract symptoms (n = 102) or refractory hematuria (n = 6) underwent prostatic artery embolization (PAE). Computed tomography and angiography images were retrospectively reviewed. The branching pattern of the internal iliac artery (IIA) was classified according to the Yamaki system. The origin of the PA was categorized using the de Assis definition, and the incidence of each type was recorded. A systematic literature review was conducted and the most common types of PA were investigated. Results: PAE was successfully implemented on 211 of the 216 pelvic sidewalls. PA cannulation failed in five sidewalls due to a steno-occlusive state. The most common IIA type was type A, in which the IIA was divided into the superior gluteal artery and gluteal-pudendal trunk (77%). Of 226 PAs analyzed, including 15 in 211 sidewalls exhibiting dual PAs, the most common PA origin was the internal pudendal artery (type IV, 35%), followed by the superior vesical (type I, 25%) and obturator (type III, 21%) arteries. Anterior division of IIA (type II) was less common (10%). Type V (uncommon origins) occurred in 8% of cases, including five distal internal pudendal arteries, four quadfurcations, three inferior gluteal arteries, three trifurcations, two medial femoral circumflex arteries, and two rectal arteries. Two of the five patients with surgically or endovascularly altered anatomy were successfully treated via PAs originating from the medial femoral circumflex arteries. Globally, type I is the most common PA type. Conclusion: In the Korean population, the most common IIA pattern and PA origin were types A and IV, respectively.

Keywords

Acknowledgement

We thank Gain Kim (Biomedical art, Incheon Catholic University) for the informative illustration.

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