Prostate-supplying arteriogram created by multidetector-row CT during pelvic arteriography: contribution to the treatment strategy of prostatic artery embolization for prostatic hyperplasia

Abstract

We describe an 85-year-old man suffering lower urinary tract symptoms, who underwent prostatic artery embolization (PAE) based on a prostate-supplying arteriogram created with multidetector-row computed tomography during pelvic arteriography. This arteriogram was synthesized from a background bone volume-rendered (VR) image, an aorta-pelvic artery VR image, and a prostate-supplying artery VR image. Because the bone background VR image is combined with the aorta-pelvic artery VR image, the prostate-supplying arteriogram can simultaneously show the pelvic branch arteries present on the ventral side, inside, and the dorsal side of the pelvic bone. It showed that the left prostatic artery supplied the urethra at the outlet of the urinary bladder. PAE of the left prostatic artery was performed with catheter navigation based on the prostate-supplying arteriogram. There was marked relief of the lower urinary tract symptoms at the 12-month follow-up.

Tardive intermittent massive vaginal bleeding from abnormal blood vessels within cesarean scar: Two more new cases should bring our attention to a new entity

“…Pelvic arteriogram can help in making a definitive diagnosis of abnormal uterine bleeding and also can be therapeutic with embolization, which has been well described to successfully treat life‐threatening vaginal hemorrhage by different studies . However, pelvic arteriogram was not available in our hospital at the time when the two patients presented.…”

“…Pelvic arteriogram can help in making a definitive diagnosis of abnormal uterine bleeding and also can be therapeutic with embolization, which has been well described to successfully treat life-threatening vaginal hemorrhage by different studies. 8,9 However, pelvic arteriogram was not available in our hospital at the time when the two patients presented. Considering the nonresponse to ordinary treatments for uterine bleeding, the patients' desired fertility, and the finding of precise structural lesions in the two cases, we carefully performed surgery in light of the advantages of the surgical procedure compared to the other medical managements for abnormal uterine bleeding in reproductive-aged women.…”