الفهرس | Only 14 pages are availabe for public view |
Abstract Background Benign prostatic hyperplasia (BPH) is the most prevalent benign tumor in aged men, and its prevalence is rising with age reaching 8% in the fourth decade of life and up to 90% in the ninth decade. PAE has long been considered as a safe and effective minimally invasive therapy option for individuals with moderate to severe lower urinary tract symptoms caused by prostatic hypertrophy. Because of the varying degrees of atherosclerosis seen in the elderly, PAE is generally a difficult treatment that necessitates a particular amount of knowledge of anatomy and a specific set of abilities. It is critical to emphasize anatomical information about PA that is required for a successful PAE, as well as radiation exposure factors that can be helpful in such a protracted treatment. This thesis provides a pictorial review of PA anatomy and prevalence of related anatomical variants, besides additional anatomical and radiation dosage concerns, and knows the important effect of the anastomosis on non-target embolization as in our study we included large number of cases (83 patients) to cover all types of variations and different types of anastomosis all were covered. Results A total of 83 patients (166 sides) were analyzed. Double arterial supply on the same side was noted in 1 patient (1.2%). In 3 patients (3.6%), only a unilateral PA was identified. PA origin frequencies were computed. Penile, rectal, vesical anastomoses, and anastomosis with the other side were identified with 7 (8.4%), 3 (3.6%), 2 (2.4%), and 8 (9.6%) of PAs, respectively. Mean skin radiation dose was 479 mGy. Conclusions When treating BPH with PAE, understanding PA anatomy is critical for achieving the best results. The anatomy of the PA is critical for preventing non-target embolization and is directly related to the correct identification of the anatomical pattern of the prostate arteries, and we should also take into account the presence of contralateral anastomoses; it is possible to achieve both prostate lobes through catheterization of the prostatic artery on only one side Prostatic artery embolization (PAE) is a safe minimally invasive, image guided therapy for symptomatic relief in patients with prostate enlargement/benign prostatic hyperplasia associated with benign prostatic hyperplasia with minimal post procedural complications. A thorough understanding of PA anatomy is required for treating BPH with PAE in order to improve technical success, decrease problems related to non-target embolization, shorten the procedure, and limit radiation exposure. There is insufficient data to support the regular use of preoperative CTA and intraoperative CBCT to improve safety or effectiveness. In this regard, randomised controlled trials are necessary. In our study we found that the most common origin was type I prostatic artery with nearly one third of the cases of the prostatic artery origin was from this type. |