Vascular Institute Central Switzerland, Aarau, Switzerland.
University of Applied Sciences Furtwangen, Villingen-Schwenningen, Germany.
Cardiovasc Intervent Radiol. 2023 May;46(5):610-616. doi: 10.1007/s00270-023-03412-2. Epub 2023 Mar 22.
This all-comers registry aimed to assess safety and early efficacy of venous embolization in patients with venogenic erectile dysfunction due to venous leak in an unselected cohort.
Between October 2019 and September 2022, patients with venogenic erectile dysfunction resistant to phosphodiesterase-5-inhibitors were treated with venous embolization using ultrasound-guided anterograde access via a deep dorsal penile vein in a single center. A mix of ethiodized oil and modified cyanoacrylate-based glue n-butyl 2 cyanoacrylate (NBCA) monomer plus methacryloxy-sulpholane monomer (Glubran-2, GEM, Italy) was used as liquid embolic agent. Prior to embolization, venous leak had been verified based on penile duplex sonography and computed tomography cavernosography. Procedural success was defined as technically successful and complete target vein embolization. The primary safety outcome measure was any major adverse event 6 weeks after the procedure. The primary feasibility outcome measure was IIEF-15 (International Index of Erectile Function-15) score improvement ≥ 4 points in ≥ 50% of subjects on 6 weeks follow-up post intervention.
Fifty consecutive patients (mean age 61.8 ± 10.0 years) with severe erectile dysfunction due to venous leak underwent venous embolization. Procedural success was achieved in 49/50 (98%) of patients with no major adverse events on follow-up. The primary feasibility outcome measure at 6 weeks was reached by 34/50 (68%) of patients.
Venous leak embolization via deep dorsal penile vein access using a liquid embolic agent was safe for all and efficacious in the majority of patients with severe venogenic erectile dysfunction on 6 weeks follow-up.
本研究旨在评估静脉漏性勃起功能障碍患者采用超声引导顺行深背静脉入路进行静脉栓塞的安全性和早期疗效。
2019 年 10 月至 2022 年 9 月，在一家中心，对磷酸二酯酶-5 抑制剂耐药的静脉性勃起功能障碍患者，采用超声引导顺行深背静脉入路进行静脉栓塞治疗。采用超声引导顺行深背静脉入路，使用包含碘化油和改良氰基丙烯酸酯基胶（n-丁基 2 氰基丙烯酸酯（NBCA）单体加甲基丙烯酰氧基-磺烷单体（Glubran-2，GEM，意大利）的混合液作为液体栓塞剂。在栓塞前，基于阴茎双功能超声和计算机断层海绵造影术，对静脉漏进行了验证。技术成功定义为手术成功和完全栓塞目标静脉。主要安全性终点是术后 6 周的任何重大不良事件。主要可行性终点是在 6 周的干预后随访中，至少 50%的患者 IIEF-15（国际勃起功能指数-15）评分提高≥4 分。
50 例连续患者（平均年龄 61.8±10.0 岁）因静脉漏导致严重勃起功能障碍，接受静脉栓塞治疗。49/50（98%）例患者达到手术成功，随访期间无重大不良事件。6 周时达到主要可行性终点的患者为 34/50（68%）。
通过深背静脉入路采用液体栓塞剂进行静脉漏栓塞术对所有患者均安全，在严重静脉性勃起功能障碍患者中，大多数患者在 6 周随访时有效。
