Abstract No. 188 Correlation of Anatomical Origins Between Left-Side and Right-Side Prostate Arteries During Prostatic Artery Embolization

Prostatic artery embolization (PAE) has proven effective in the control of lower urinary tract symptoms of benign prostatic hyperplasia but is performed in an anatomically complex field and identification of prostate artery (PA) origin could be challenging. We hypothesized that there is a correlation between the bilateral origins of the arteries, helping the identification of the PAs during PAE. Pelvic digital subtraction arteriogram of med (DSA) who underwent a bilateral PAE were reviewed, and the type of PA origin was documented based on the previously published classification system (type 1: origin from vesical artery, type 2: from anterior division below vesical artery, type 3: from obturator artery, type 4: from internal pudendal artery). Evaluation of DSA was performed by one vascular interventional radiologist with more than 5 years of experience after fellowship training. If patients had 4 or more feeders to the entire prostate gland they were excluded from the study. When accessory PAs were encountered, the feeding artery with prominent supply to the transition zone of that side was considered the main PA for that side and the origin type of that vessel was recorded. When the prostatic artery originated from the corona mortis variant it was considered an obturator artery type origin (type 3). Patients with a type 5 origin (rare variants) were excluded from the analysis due to the low number would not allow enough statistical power. The percentage of patients with matched types of origins was calculated and reliability test was conducted using Cronbach's alpha measurement. Cronbach's alpha greater than 0.65 was considered strong. Total of 150 men (300 pelvic sides) were reviewed. The mean (SD) age was 72 (9). 112 patients (75%) had similar type of origin of the prostatic arteries when sides were compared. The correlation was not different between the different types of origins. The Cronbach's alpha was calculated at 0.78 (high). After any side's PA origin is identified, on average there was 75% chance that other side has similar type of PA origin (77% for type 1, 80% for type 2, 68% for type 3, 75% for type 4). The anatomical origin of the prostate arteries is highly correlated between the left and right sides, and this may increase the chance of successful identification of prostatic arteries and possibly help choosing the correct device for catheterization of arteries during PAE.