Monday, October 12, 2009

DES ( DRUG ELUTING STENT ) FOR ERECTILE DYSFUNCTION ( ED )

Towards the conclusion of the recently concluded TCT 2009 at San Francisco, Dr Jason H Rogers ( UC Davis Medical Center, Sacramento ) rose up to announce the launch and recruitment of patients for a new study called the ZEN trial. This is a trail to show that implanting a zotarolimus eluting stent in the internal pudendal artery, could help patients with erectile dysfunction. What will we think of next. This study will be sponsored by Metronic International, the maker of the zotarolimus eluding stent. In fact the imvestigators had done an earlier pilot study, the PANPI ( Pelvic angiography in non-responders to PD-5 inhibitors ) study.
What was revealed in PANPI was very interesting 70 % of patients with CAD suffers from ED ( erectile dysfunction ). When they did angiography on their sample patients with ED, there was a 100% correlation with CAD ( meaning that all those who had arterial blockage of their internal pudendal artery also had CAD ). And ED predates CAD by about 36 months. It would appear that the authors concluded that ED that does not respond to phosphodiesterase-5 inhibitors ( drugs like viagra ) are liely to be due to arteriosclerosis of their internal pudendal artery.
A point of clarification. The penis ( without going into a lot of jargon ) is supplied by the left and right internal pudendal arteries, which are branches of the left and right internal iliac arteries. Just as cholesterol can accumulate in the walls of heart arteries ( coronary arteries ), it can also accumulate in the internal pudendal arteries. Apparently the risk factors of pudendal artery arteriosclerosis is the same as that of coronary arteries. Looks like taking care of your cardiac health is also taking care of your sexual health. Maybe making this fact known will help to cut down cigarette smoking.
What was also interesting from the PANPI study was that the authors noted that when patients were told that they have both CAD and arteriosclerosis of their internal pudendal arteries, they wanted to have stenting done to help their ED first. Looks like for some, sex is more important than life.
Perhaps the other lesson that we should learn is that, cardiologist and family physicians should ask more often about sexual habits in an attempt to diagnose CAD, since they have a 100% correlation especially in those with phospho diesterase-5 inhibitors resisitance.

5 comments:

Health News said...

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