Cone-Beam CT-assisted navigation for endovascular treatment of erection-related artery stenosis in patients with erectile dysfunction

Abstract

Background Angioplasty and stenting have emerged as endovascular treatment options for arteriogenic erectile dysfunction over the past few years. Considerable anatomical variation of the erection related pelvic arteries can be challenging during these procedures, leading to time-consuming repetitive super-selective angiograms for navigation. Technique We report a novel technique of using C-arm Cone-Beam CT and vessel navigation software to facilitate super-selective catheterization. Conclusion Cone-Beam CT-guided navigation for vascular assessment of arteriogenic ED is an optional approach compared to exclusive angiographic assessment. Compared to CT angiography, C-arm Cone-Beam CT offers benefits regarding usage of contrast media and radiation exposure. It has the advantage to combine imaging with endovascular procedures in a single session, reduces time to target navigation in complex pelvic arteries anatomy and may increase therapy safety in endovascular treatment of ED.

Endovascular penile revascularization improves erectile dysfunction in patients with penile arterial insufficiency

“…Selective angiographic assessment of the erection-related arteries solely guided by conventional digital subtraction angiography can be challenging and time consuming due to the complexity and anatomic variability of pelvic arteries. 9 However, several techniques have made IPA identification easier. In patients with preoperative CTA, an image fusion software system can be used to guide lesion identification.…”

“…The root of the penis and the tip of the diagnostic catheter are set as markers for software-automated vessel track calculation and construction of a 3-dimensional modelling of the vascular tree to reduce time to target lesion and to increase interventional safety. 9 Immediately after the procedure, an oral loading dose of 300 mg clopidogrel is usually administered. Patients are also maintained on acetylsalicylic acid and clopidogrel (75 mg/d) for 12 months.…”

“…8 Vascular ED effects 60-80% of patients with erectile dysfunction older than 50 years. 6,9 Penile erection is a neurovascular event modulated by psychological and hormonal factors. On sexual stimulation, an increase in parasympathetic activity causes the release of neurotransmitters from the nerve terminals in the penis.…”