Lesion Pattern in Patients With Erectile Dysfunction of Suspected Arterial Origin: An Angiographic Study.

von Allmen, Regula S; Nguyen, Daniel P.; Birkhäuser, Frédéric D.; Bednar, Rudolf; Kammer, Rafael; Do, Dai-Do; Diehm, Nicolas (2016). Lesion Pattern in Patients With Erectile Dysfunction of Suspected Arterial Origin: An Angiographic Study. Journal of endovascular therapy, 23(1), pp. 76-82. Sage 10.1177/1526602815613789

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To determine the specific lesion pattern of supplying arteries in patients with cardiovascular risk factors suffering from treatment-refractory erectile dysfunction (ED).


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).


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).


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.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Nguyen, Daniel Truong Phat, Bednar, Rudolf, Kammer, Rafael Franz, Do, Dai-Do


600 Technology > 610 Medicine & health








Isabel Lorenz

Date Deposited:

04 Feb 2020 10:05

Last Modified:

05 Dec 2022 15:35

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

angioplasty cardiovascular disease erectile dysfunction internal iliac artery internal pudendal artery microangiopathy occlusion peripheral artery disease stenosis stent





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