Arterial Interventions and Peripheral Arterial Disease (PAD)

Session: Educational Exhibit Presentations - Station 12: Women's & Men's Health

An Atlas of Prostatic Artery Anatomy

Monday, March 6, 2023

5:25 PM – 5:30 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

Anthony R. Zamary, MS

Medical Student
Kaiser Permanente School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Kevin Zhou, BA

Medical Student
Kaiser Permanente School of Medicine
Alexander Andrew Argame, BSN, RN (he/him/his)

Medical Student
Kaiser Permanente Bernard J. Tyson School of Medicine
CF

Caroline Ferguson-Dryden, BA

Medical Student
Kaiser Permanente School of Medicine
Kartik Kansagra, MD

Vascular and Interventional Physician
KP VISLA
GV

Geogy Vatakencherry, MD, FSVM,FSIR

Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente physician
AB

Alok Bhatt, MD

Assistant Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente Los Angeles

Disclosure(s):

Anthony R. Zamary, MS: No financial relationships to disclose

Kevin Zhou, BA: No financial relationships to disclose

Alexander Andrew Argame, BSN, RN: No financial relationships to disclose

Kartik Kansagra, MD: No financial relationships to disclose

Geogy Vatakencherry, MD FSIR: No financial relationships to disclose

Learning Objectives:

Learning Objectives: To present a pictorial atlas of prostatic artery anatomy relevant to prostatic artery embolization. This includes a review of common classification systems, such as Yamaki Branching Classification and Carnevale Classification, as well as dangerous anastomoses, collateral identification, and clinically important vascular variants.

Background:

Background: Benign prostatic hyperplasia (BPH) affects 80% of men by age 80. The often-associated lower urinary tract symptoms (LUTS) can greatly decrease quality of life. Prostatic artery embolization (PAE), among other minimally invasive surgical techniques (MISTs), is an effective treatment performed by interventional radiologists that has been shown to improve LUTS and reduce prostatic volume. Although understanding prostatic artery anatomy is key for intervention, arterial anatomy is highly varied among individuals. Multiple systems of classifying arterial anatomy by number, origin, anastomoses, incidence of atherosclerosis, branching, and type have been attempted. In this educational exhibit, we seek to provide an atlas of prostatic artery anatomy.

Clinical Findings/Procedure Details:

CLINICAL FINDINGS/PROCEDURE DETAILS:

This exhibit will:

1. Provide a pictorial review of prostatic artery anatomy and classifications by Carnevale et al. and Yamaki et al.

2. Describe the frequency of the previously classified variants based on current literature.

3. Describe the vascular navigation involved in PAE.

4. Identify and describe dangerous anastomoses and collaterals.

5. Identify and describe clinically important vascular variants, including blood supply, size, and vascular compartmentalization.

Conclusion and/or Teaching Points:

CONCLUSION AND/OR TEACHING POINTS: Knowledge of prostatic artery anatomy and its variants is critical to performing successful PAE. PAE is an important therapy for BPH performed by interventional radiologists. Highlighting key imaging findings of PA anatomy variations can help an interventional radiologist determine a procedural approach or alternative therapy option. The atlas of PA anatomy presented here exhibits important PA anatomy variations essential to successful MIST, which can greatly improve a patient’s quality of life.