Implication of prostate artery characteristics on digital subtraction angiography in prostate artery embolization in the treatment of benign prostatic hyperplasia

The aim of this study is to analyze the implication of anatomical characteristics of prostatic arteries (PAs) on digital subtraction angiograms (DSAs) in patients with benign prostatic hyperplasia (BPH). This is a cross-sectional descriptive study on the DSA results of 106 male patients with BPH at the Diagnostic Imaging and Interventional Radiology Center, Tam Anh General Hospital, Hanoi from January 2022 to January 2024. This study was conducted on 106 patients undergoing iliac artery angiography on DSA, 208 PAs were found. In these cases, in 96% of cases, one PA was found on one side, and in 4%, two independent PAs were found. Regarding the origin of the PA according to Francisco Carnevale’s classification, the ratio of type I (common trunk with superior vesical artery (SVA)), type II (anterior division of the internal iliac artery (IIA), inferior to SVA), type III (obturator artery), type IV (internal pudendal artery), and type V (other locations) were 48%, 15.1%, 17.8%, 18.7%, and 0.4%, respectively. The average diameter of the PA was 1.58±0.28 mm. Regarding shape, 69.7% of PA origins were straight, and 30.3% of PA origins were tortuous. Atherosclerosis of PAs accounted for 14.9%. The anastomosis between PAs and surrounding arteries included contralateral PAs (43%), penis (35%), rectum (17.1%), bladder (4.3%), seminal vesicles (4.8%), and other locations (1%). While the most common anastomoses are to the contralateral PA, attention should be paid to the anastomoses to the penis and rectum to avoid complications in PA embolization (PAE) intervention.