Balloon angioplasty benefits some men with erectile dysfunction, penile artery stenoses

Balloon angioplasty achieved durable clinical improvement in some men with erectile dysfunction and isolated penile artery stenoses, according to results of the PERFECT-2 study.

Tzung-Dau Wang, MD, PhD, FESC, and colleagues assessed the angiographic durability of plain old balloon angioplasty for penile artery stenoses as well as predictors and clinical impacts in men with erectile dysfunction.

Tzung-Dau Wang

Twenty-eight patients with erectile dysfunction (mean age, 61 years; mean International Index of Erectile Function 5-item brief form [IIEF-5] score, 10) underwent balloon angioplasty. Clinical follow-up was conducted at 1, 3 and 6 months and CT angiographic follow-up at 6 to 9 months. Twenty-two patients with 34 lesions had clinical follow-up at 12 months.

The primary angiographic endpoint was CT angiographic binary restenosis (diameter stenosis ≥ 50%). The primary clinical endpoint was change in IIEF-5 score and the definition of clinical success was achievement of IIEF-5 score of at least 22 or change in IIEF-5 score from baseline by at least four points.

At 6- to 9-month CTA follow-up, mean minimal diameter increased from 0.44 mm to 1.14 mm, mean diameter stenosis declined from 74.9% to 36.7% and mean lesion length declined from 11.1 mm to 4.3 mm (P < .001 for all), Wang, from the cardiovascular center and division of cardiology, department of internal medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei City, Taiwan, reported at EuroPCR.

Binary restenosis occurred in 14 of 34 lesions (41%), 13 of 26 vessels (50%) and 13 of 22 patients (59%).

Compared with those who had lesions with binary restenosis, patients who did not have lesions with binary restenosis were younger (59 years vs. 63 years; P = .049) and had larger average reference vessel diameter (1.81 mm vs. 1.57 mm; P = .046), Wang said.

At 12 months, clinical success was achieved in 12 patients (55%), and five (23%) achieved IIEF-5 score of at least 22. Mean change in IIEF-5 score was 5.4 at 1 month, 5.8 at 2 months, 5.3 at 6 months and 4.7 at 12 months (P < .001 for all), according to the researchers.

Men who achieved clinical success were younger (57.3 years vs. 65.3 years; P = .027) and less likely to have binary restenosis (33% vs. 90%; P = .007) compared with men who did not achieve clinical success, Wang said.

“We, for the first time, demonstrated that penile artery plain old balloon angioplasty could achieve durable clinical improvement in 55% of patients with erectile dysfunction and isolated penile artery stenoses 12 months following intervention,” Wang said. “However, an approximately 40% restenosis rate was found, which usually happened in smaller vessels and was closely related to treatment failure. Our findings highlight and unmet need for a more enduring treatment modality for penile artery stenotic diseases.” – by Erik Swain

Reference:

Wang T, et al. Hot Line: Peripheral Interventions. Presented at: EuroPCR; May 19-22, 2015; Paris.

Disclosure: Wang reports no relevant financial disclosures.