Impact of anatomy type of prostatic artery on the number of catheters needed for prostatic artery embolization

Purpose The purpose of this study was to assess the relationship between the number of microcatheters required for prostatic artery embolization (PAE) and the anatomy of the prostatic artery (PA). Materials and methods All consecutive patients who underwent PAE between May 2017 and December 2018 were included. The anatomical description of the PAs was assessed by both global cone beam computed tomography and selective angiography and data on the resources used, in terms of microcatheters, were prospectively collected. Results A total of 215 consecutive patients (mean age, 66 ± 8.7 [SD] years; range: 45–93 years), with a mean International Prostate Symptom Score of 21 ± 7.4 (SD) and a mean prostate volume on magnetic resonance imaging of 88 ± 38 (SD) mL (range: 30–200 mL) underwent PAE. A single PA was observed in 347 hemipelvises (347/411; 84.4%) and double PAs in 64 (64/411; 15.6%). Eighty percent (173/215 patients) of PAEs were performed using a single microcatheter. Type I PA anatomy required significantly more microcatheters (1.15 ± 0.39 [SD]; range: 1–3), than type II (1.04 ± 0.19 [SD]; range: 1–2), type III (1.09 ± 0.34 [SD]; range: 1–3) and type IV (1.06 ± 0.27 [SD]; range: 1–2) (P = 0.01 for all). Conclusion PAE is feasible with limited per-intervention changes in devices for all types of PA anatomy encountered. This could help in the design of appropriate reimbursement policies in various healthcare settings.