Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Radiology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Korean J Radiol. 2024 Nov;25(11):1011-1021. doi: 10.3348/kjr.2024.0451.
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.
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.
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.
In the Korean population, the most common IIA pattern and PA origin were types A and IV, respectively.
本研究旨在分析前列腺动脉（PA）在韩国人群中的起源，并与文献报道进行比较。
2018 年 4 月至 2024 年 2 月，108 例男性（平均年龄±标准差：71.6±9.7 岁）因下尿路症状（n=102）或难治性血尿（n=6）接受前列腺动脉栓塞术（PAE）。回顾性分析计算机断层扫描和血管造影图像。根据 Yamaki 系统对髂内动脉（IIA）的分支模式进行分类。根据 de Assis 定义对 PA 的起源进行分类，并记录每种类型的发生率。进行了系统的文献回顾，并调查了最常见的 PA 类型。
216 个骨盆侧壁中有 211 个成功实施了 PAE。由于狭窄闭塞状态，5 个侧壁的 PA 插管失败。最常见的 IIA 类型是 A 型，其中 IIA 分为臀上动脉和臀-阴部干（77%）。在分析的 226 条 PA 中，包括 15 条来自 211 条侧壁的双 PA，最常见的 PA 起源是阴部内动脉（IV 型，35%），其次是膀胱上动脉（I 型，25%）和闭孔动脉（III 型，21%）。IIA 的前部分支（II 型）较少见（10%）。V 型（少见起源）占 8%，包括 5 条远端阴部内动脉、4 个四叉、3 条臀下动脉、3 个三叉、2 条股内侧旋骼动脉和 2 条直肠动脉。5 例解剖结构经手术或血管内改变的患者中有 2 例通过起源于股内侧旋骼动脉的 PA 成功治疗。总体而言，I 型是最常见的 PA 类型。
在韩国人群中，最常见的 IIA 模式和 PA 起源分别为 A 型和 IV 型。
