Laboratory Investigation
Human Cadaveric Specimen Study of the Prostatic Arterial Anatomy: Implications for Arterial Embolization

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Abstract

Purpose

To describe and illustrate the prostatic arterial anatomy from human cadaveric specimens, highlighting implications for prostatic arterial embolization.

Materials and Methods

Dissection of 18 male pelves from white adults 35–68 years old was performed in the anatomy laboratory. Arterial branches were identified according to standard dissection technique using a 20-diopter magnifying lens for the prostatic sector. The branches were colored with red acrylic paint to enhance contrast and improve visualization.

Results

Two main arterial pedicles to the prostate from each hemipelvis were identified in all cadaveric specimens: the superior and inferior prostatic pedicles. The superior prostatic pedicle provides the main arterial supply of the gland and provides branches to both the inferior bladder and the ejaculatory system. The inferior prostatic pedicle distributes as a plexus in the prostatic apex and anastomoses with the superior pedicle. This pattern of prostatic arterial distribution was constant in all cadaveric specimens. In contrast, the origin of the superior prostatic pedicle was variable from different sources of the internal iliac artery.

Conclusions

The description and illustration of the prostatic arterial anatomy, as demonstrated by this cadaveric study, may provide useful information and guidance for prostatic arterial embolization.

Section snippets

Materials and Methods

This study was performed under the ethical rules and regulations of the School of Medicine that allow dissection of human cadaveric specimens for scientific investigations. Dissection of 18 male pelves (36 hemipelves) from white adults 35–68 years old was performed in the anatomy laboratory. Anatomic dissections were performed by senior dissectors with > 10 years of experience. Each specimen required 30–45 working hours for vessel dissection and 10 additional hours for vessel painting.

The

Distal Termination

Two main arterial pedicles to the prostate from each hemipelvis were identified in all studied specimens: the superior and inferior prostatic pedicles. Their direction and distribution were constant in all pelves dissected (Fig 1).

The superior pedicle, called the prostatic artery, entered the gland in the posterior-superior sector of its lateral border in all studied cases. Before reaching the prostate, it branched to the trigone and the seminal vesicles. The superior prostatic pedicle

Discussion

The present study describes the prostatic arterial anatomy as observed in human cadaveric specimens with an emphasis on relevant findings in the context of PAE. This anatomic study revealed the main arterial supply of the prostate by the superior prostatic arterial pedicle.

Before accessing the prostate, the superior prostatic arterial pedicle provides branches to both the inferior bladder and the seminal vesicles and divides into a medial and a lateral branch. The medial branch supplies the

Acknowledgment

The authors thank Dr. Osvaldo Velan for his significant contribution of the illustrations.

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None of the authors have identified a conflict of interest.

This original contribution has obtained an Educational Award at the SIR Congress 2012 (San Francisco) and a Cum laude at RSNA 2011 (Chicago).

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