Detection of the Vesical Arteries Using Three-dimensional Digital Subtraction Angiography Relevant to Intra-arterial Infusion Chemotherapy for Bladder Cancer Using Double-balloon Catheters

Kiyohito Yamamoto; Kazuhiro Yamamoto; Go Nakai; Tomohiro Fujitani; Shoko Omura; Haruhito Azuma; Keigo Osuga

doi:10.22575/interventionalradiology.2022-0030

Detection of the Vesical Arteries Using Three-dimensional Digital Subtraction Angiography Relevant to Intra-arterial Infusion Chemotherapy for Bladder Cancer Using Double-balloon Catheters

Interv Radiol (Higashimatsuyama). 2023 Jun 3;8(2):64-69. doi: 10.22575/interventionalradiology.2022-0030. eCollection 2023 Jul 1.

Authors

Kiyohito Yamamoto¹, Kazuhiro Yamamoto¹, Go Nakai¹, Tomohiro Fujitani¹, Shoko Omura¹, Haruhito Azuma², Keigo Osuga¹

Affiliations

¹ Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Japan.
² Department of Urology, Osaka Medical and Pharmaceutical University, Japan.

PMID: 37485483
PMCID: PMC10359176
DOI: 10.22575/interventionalradiology.2022-0030

Abstract

Purpose: This study aims to assess and measure the origin of the superior vesical artery and its distance from the anterior trunk of the internal iliac artery, to which the anticancer drug is infused via double-balloon-occluded arterial infusion bladder-preserving therapy for locally invasive bladder cancer.

Material and methods: The 160 pelvic sides of 80 patients were analyzed. Double-balloon catheters were bilaterally introduced into the contralateral superior gluteal artery via the internal iliac arteries using a bilateral transfemoral approach. The proximal balloon is placed at the internal iliac artery, proximally from superior gluteal artery bifurcation, whereas the distal balloon at the origin of the superior gluteal artery to isolate the anterior trunk of the internal iliac artery discharging to the targeted vesical arteries between the balloons. The side hole between the distal and proximal balloons was adjusted at the origin of the anterior trunk of the internal iliac artery to allow clear visualization of the angiographic flow into the bladder. After the distal and proximal balloons were inflated, three-dimensional rotational digital subtraction angiography was performed by simultaneous contrast injection from one extension tube connected to bilateral catheters. The distance (X) between the origins of anterior trunk of the internal iliac artery and superior vesical artery was measured on three-dimensional digital subtraction angiography images, and the origin of the inferior vesical artery was investigated.

Results: All superior vesical artery originated from anterior trunk of the internal iliac artery. The mean x was 7.2 mm (range 1.0-22.0 mm). All inferior vesical arterys branched from anterior trunk of the internal iliac artery or its branches.

Conclusions: Superior vesical artery commonly originates from the proximal portion of anterior trunk of the internal iliac artery close to superior gluteal artery bifurcation.

Keywords: double-balloon catheter; double-balloon-occluded arterial infusion; invasive bladder cancer; three-dimensional digital subtraction angiography; vesical artery.