scholarly journals Types of the prostate blood supply during super-selective embolization of prostatic arteries

2021 ◽  
Vol 9 (3) ◽  
pp. 32-43
Author(s):  
S. A. Kapranov ◽  
A. G. Zlatovratskiy ◽  
V. K. Karpov ◽  
B. M. Shaparov ◽  
A. A. Kamalov
Keyword(s):  
Digital Subtraction Angiography ◽  
Blood Supply ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Digital Subtraction ◽  
Selective Embolization ◽  
Internal Iliac ◽  
Invasive Method ◽  
Msct Angiography ◽  
Prostatic Artery

Introduction. Pelvic arteries have various anatomy and anastomoses with other branches of the internal iliac artery (IIA). This explains the technical complexity of identification and catheterization of prostatic arteries (PA), as well as the possibility of complications associated with non-target embolization of prostatic artery anastomoses.Purpose of the study. To analyze the most common variants of prostate blood supply and evaluate the effectiveness of methods for identifying prostatic arteries.Materials and methods. The study included 168 patients treated from 2013 to 2021. For catheterization of the prostatic arteries, 4 – 5 Fr microconductors and 2 – 2.8 Fr microcatheters were used. For embolization, hydrogel microspheres with a diameter of 100 – 300 µm and 300 – 500 µm were used, as well as PVA microparticles with a diameter of 100 – 500 µm. Preoperatively multi-sliced computed tomography (MSCT) angiography of the pelvic organs was performed to determine the type of prostatic angioarchitectonics.Results. The use of preoperative MSCT angiography in combination with intraoperative digital subtraction angiography made it possible to determine the variations of prostatic artery divergence and identify their anastomoses in 100% of patients (336 pelvic sides). One prostatic artery was detected in 91.4% (307) of the pelvic sides. two independent pAs in 8.6% (29) of cases. Symmetrical anatomy of the prostatic arteries on both sides was revealed in 14.3% (24) patients, the remaining 85.7% (144) patients showed asymmetry on both sides. The absence of prostatic arteries anastomoses was detected in 75.5% (254) of the pelvic sides, and in 24.4% (82) of the pelvic sides, anastomoses were detected. Interlobar intraprostatic anastomoses were found in 10.1% (34) of the pelvic sides, communication with a. dorsalis penis was detected in 8% (27) of cases, with rectal arteries in 5.3% (18) of the pelvic sides and with urinary bladder arteries in 3.6% (12) of cases. Based on the analysis of the small pelvis angioarchitectonics in 168 patients, an anatomical classification of the prostatic arteries anatomy was proposed.Conclusion. Super-selective embolization of the prostatic arteries is a contemporary minimally invasive method of prostatic hyperplasia treatment with a high safety profile. The pelvic arteries have extremely various anatomy, as well as anastomoses with other branches of the internal iliac artery, which complicates the implementation of super-selective embolization of prostatic arteries. The combination of preoperative MSCT and intraoperative digital subtraction angiography makes it possible to identify the prostatic artery and its anastomoses in most cases.

scholarly journals Impact of Intermittent Functional Internal Iliac Artery Occlusion on Spinal Cord Blood Supply During TEVAR

2019 ◽  
Vol 70 (3) ◽  
pp. 1009-1010
Author(s):  
S. Maier ◽  
J. Morlock ◽  
C. Benk ◽  
F.A. Kari ◽  
M. Siepe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cord Blood ◽  
Blood Supply ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Occlusion ◽  
Iliac Artery Occlusion ◽  
Internal Iliac ◽  
Spinal Cord Blood Supply

scholarly journals Treatment of Massive Bladder Hemorrhage of Cancerous Etiology Using Selective Embolization

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 69s-69s
Author(s):  
T. Ząbkowski ◽  
P. Piasecki ◽  
L. Bodnar ◽  
T. Syryło ◽  
H. Zieliński ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Fresh Frozen Plasma ◽  
Therapeutic Success ◽  
Selective Embolization ◽  
Packed Red Blood Cells ◽  
Internal Iliac ◽  
Fresh Frozen ◽  
Anterior Division ◽  
Muscle Invasive

Background: Massive and intractable bladder hemorrhage of cancerous etiology are very dangerous and directly life-threatening. Its treatment is very difficult and complicated because of the severity of bladder tumor and the general poor condition of the patient which does not enable a radical surgical treatment. Aim: To evaluate the efficiency of the treatment of massive bladder hemorrhage of cancerous etiology using internal iliac artery selective embolization of anterior division. Methods: From January 2006 through June 2015, 23 patients (17 male and 6 female) were admitted to Urology Department as a matter of urgency because of massive bladder hemorrhage of cancerous etiology secondary to muscle-invasive bladder cancer (MIBC) - 14 patients, rectal cancer (RC) with invading bladder - 2 patients, bowel cancer with invading bladder - 2 patients, prostate cancer (PC) with invading bladder - 3 patients and cervical cancer with invading bladder - 2 patients ( Fig 1 ). The mean age of patients was 63.5 (range 37-80). In all patients, internal iliac artery selective embolization of anterior division was performed. The baseline mean hematocrit level during admission of patients to hospital was 23%, after embolization - 27.5%. In 14 patients it was necessary a mean of 6 transfusion units of packed red blood cells (PRBCs), range 2-16 transfusion units of PRBCs. 6 patients also required a mean of 8 transfusion units of fresh frozen plasma (FFP), range 2-27 transfusion units of FFP. Results: In 20 (86.96%) patients, therapeutic success was achieved after the first procedure. In 3 (13.04%) patients who developed hematuria after 12-38 days from the first endovascular procedure, the next successful embolization was performed bilaterally. It was not developed any major complications after embolization. Conclusion: Embolization of internal iliac artery is considered as a highly effective and minimally invasive method in case of massive bladder hemorrhage of cancerous etiology.[Figure: see text]

scholarly journals Fornix Rupture in Duplex Kidney due to Internal Iliac Artery Aneurysm

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Phitsanu Mahawong ◽  
Tanop Srisuwan ◽  
Kittipan Rerkasem
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Aneurysm ◽  
Abdominal Ultrasound ◽  
Selective Embolization ◽  
Iliac Artery Aneurysm ◽  
Duplex Kidney ◽  
Internal Iliac Artery Aneurysm ◽  
Internal Iliac ◽  
The Right

A 70-year-old man presented with severe pain on the right side of the abdomen for 7 days. An abdominal CT angiographic scan showed an impending rupture of a large right internal iliac artery aneurysm which compressed to a right ureter causing hydroureteronephrosis. Fornix rupture of a right duplex kidney was also detected. Selective embolization of right gluteal arteries and then ligation of the right internal iliac artery and right ureterotomy with double J stenting were performed. At the 4-month follow-up appointment, an abdominal ultrasound demonstrated a decrease in the size of the aneurysm and no hydroureteronephrosis after the removal of double J stent.

scholarly journals Postpartum Hemorrhage Resulting from Internal Iliac Artery Pseudoaneurysm

2020 ◽  
Vol I (2) ◽  
pp. 26-28
Author(s):  
Gözde Girgin
Keyword(s):  
Iliac Artery ◽  
Postpartum Hemorrhage ◽  
Internal Iliac Artery ◽  
Normal Vaginal Delivery ◽  
Artery Ligation ◽  
Selective Embolization ◽  
Artery Pseudoaneurysm ◽  
Ct Angiogram ◽  
Internal Iliac ◽  
Iliac Artery Pseudoaneurysm

We describe a case of internal iliac artery pseudoaneurysm in a 38-year-old woman with postpartum hemorrhage following uterine artery ligation and uterine rupture repair. A 38-year-old female without any comorbid conditions or diseases who had previously given birth with a normal vaginal delivery was admitted to an external healthcare center with pain. The patient presented to our hospital on the 7th postoperative day with abdominal and side pain. We diagnosed the patient with ultrasonography and CT-angiogram imaging and she was treated with selective embolization. On the second day following the procedure, a regression in the previously identified hydronephrosis was observed using renal ultrasonography. The patient was discharged on the 14th day of hospitalization when she was clinically stable. Patients presenting with abdominal pain and hemorrhage after cesarean sections should be carefully evaluated for the possibility of uncommon complications, especially pseudoaneurysms, preferably with a multidisciplinary approach.

scholarly journals Posttransurethral Resection of Prostate Recurrent Life Threatening Hematuria: A Rare Cause

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
MC Arya ◽  
Lalit Kumar ◽  
Ruchi Mittal ◽  
Rajeev Kumar ◽  
Mayank Baid
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Transurethral Resection Of Prostate ◽  
Ct Urography ◽  
Artery Ligation ◽  
Selective Embolization ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced Ct ◽  
Internal Iliac ◽  
Life Threatening

Herein, we present a case report of post-TURP (transurethral resection of prostate) recurrent severe hematuria due to right internal iliac artery pseudoaneurysm protruding into bladder lumen. A 60-year-old male presented with recurrent massive hematuria following TURP done elsewhere 15 days before. His hemoglobin was 4 gm/dL after 13 units of blood transfusion and repeated clot evacuations. His blood urea, serum creatinine, and coagulation profile studies were normal. Ultrasonography of abdomen showed multiple clots in the bladder. Cystoscopy revealed clots with a right posterolateral wall unhealthy area. After stabilizing the patient, contrast enhanced CT urography revealed intravesical aneurysm. CT angiography showed pseudoaneurysm of a branch of internal iliac artery protruding into urinary bladder lumen. We referred patient to selective embolization of the lesion but the procedure was unsuccessful. At last, ipsilateral internal iliac artery ligation relieved hematuria. But on postoperative day 2, patient suddenly collapsed and deceased, presumably due to cardiomorbidities.

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