Prostatic artery embolization (PAE) is a minimally invasive treatment for patients
with moderate to severe lower urinary tract symptoms and/or urinary retention due
to benign prostatic hyperplasia (BPH), as well as hematuria secondary to prostatic
bleeding. PAE achieves its therapeutic effect by inducing ischemic necrosis and reducing
prostatic volume, while also decreasing neuromuscular tone. This dual mechanism addresses
both the static and dynamic components of bladder outflow obstruction associated with
BPH. PAE is technically challenging and necessitates in-depth knowledge of the complex
and variable anatomy of the pelvic vasculature. Successful outcomes depend on precise
identification of the prostatic artery and recognition of anastomoses to surrounding
structures to minimize the risk of nontarget embolization and associated complications.
This article reviews the prostatic arterial anatomy and explores the role of advanced
imaging techniques for preprocedural planning and intraprocedural guidance to optimize
procedural safety and efficacy.
Keywords
prostate artery embolization - benign prostatic hypertrophy - internal iliac artery
- cone beam computed tomography - interventional radiology
