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Lesion Pattern in Patients With Erectile Dysfunction of Suspected Arterial Origin: An Angiographic Study.
- Source :
-
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2016 Feb; Vol. 23 (1), pp. 76-82. Date of Electronic Publication: 2015 Oct 28. - Publication Year :
- 2016
-
Abstract
- Purpose: To determine the specific lesion pattern of supplying arteries in patients with cardiovascular risk factors suffering from treatment-refractory erectile dysfunction (ED).<br />Methods: From May 2012 to August 2013, 26 men (median age 55 years) poorly responsive to phosphodiesterase-5 inhibitor therapy were evaluated for a possible vascular cause for their ED. The men were examined with penile duplex sonography and digital subtraction angiography (DSA). Arterial lesions in the common and internal iliac arteries and the internal pudendal arteries considered amenable to endovascular therapy were treated with angioplasty ± stents. Retrospectively, 2 blinded investigators independently evaluated the DSA images and categorized the vascular patterns of the erection-related arteries as normal, macroangiopathy (occlusive lesions of the internal pudendal arteries), or microangiopathy (smaller caliber arteries distal to the internal pudendal circulation with no distal arterial reconstitution).<br />Results: Seventeen macroangiopathic lesions were successfully treated by angioplasty in 11 patients. The treated arterial lesions were mainly located in the internal (n=10) and common iliac arteries (n=2), whereas the internal pudendal artery were involved in 5 cases. Microangiopathic lesions lacking distal reconstitution were present in 7 patients, and the remaining 8 patients had normal vessels supplying the penis. Patients with macroangiopathy undergoing angioplasty had a higher prevalence of peripheral artery disease (63.6% vs 6.7%, p=0.003).<br />Conclusion: In this preliminary series of ED patients with cardiovascular risk factors and pathologic duplex sonographic flow parameters, roughly 40% exhibited arterial lesions amenable to endovascular revascularization. In the patients with macroangiopathy, vessels upstream of the internal pudendal artery were most commonly affected. More studies are warranted to define the role of endovascular procedures in this ED subpopulation.<br /> (© The Author(s) 2015.)
- Subjects :
- Aged
Angioplasty instrumentation
Constriction, Pathologic
Humans
Impotence, Vasculogenic drug therapy
Impotence, Vasculogenic physiopathology
Male
Middle Aged
Peripheral Arterial Disease complications
Peripheral Arterial Disease therapy
Phosphodiesterase 5 Inhibitors therapeutic use
Predictive Value of Tests
Retrospective Studies
Severity of Illness Index
Stents
Treatment Failure
Ultrasonography, Doppler, Duplex
Angiography, Digital Subtraction
Iliac Artery diagnostic imaging
Impotence, Vasculogenic diagnostic imaging
Penile Erection drug effects
Peripheral Arterial Disease diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1545-1550
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Publication Type :
- Academic Journal
- Accession number :
- 26511893
- Full Text :
- https://doi.org/10.1177/1526602815613789