SIR 2024
Men's Health
Gregory Sprout, MSc
Medical Student
University of Arizona College of Medicine-Phoenix
Financial relationships: Full list of relationships is listed on the CME information page.
Tyler E. Callese, MD
Resident Physician
UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Justin McWilliams, MD, FSIR
Professor of Interventional Radiology
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Protective embolization of extra-prostatic arterial anastomoses (e.g., penile, rectal, or bladder supply) is a common practice during prostatic artery embolization (PAE) and reported in approximately 1 in 4 patients undergoing PAE {Bhatia 2017}. Published reports support protective embolization as a safe and effective method for preventing non-target embolization during PAE.
Clinical Findings/Procedure Details:
Pelvic and prostatic vascular anatomy is highly complex with numerous collateral vessels supplying adjacent pelvic organs (e.g., bladder, penis, and rectum) often anastomosing with the prostatic artery (PA). Interrogation of the PA and extra-prostatic anastomoses can be performed with planar angiography and/or cone-beam CT. If warranted, protective embolization of the identified anastomoses can be performed using microcoils to avoid nontarget delivery of particles during PAE.
Conclusion and/or Teaching Points:
Knowledge of pelvic vascular anatomy and the common variations of PA origin is essential for optimal PAE outcomes. Recognition of extra-prostatic anastomoses and appropriate use of protective embolization further improves procedural safety. This educational exhibit will detail current literature on the incidence, safety profile, and efficacy of protective embolization during PAE and illustrate examples of its real-world use.