Stents Help Some Erectile Dysfunction
By medpagetoday.com
Stenting blocked arteries in the pelvis may improve sexual function for certain men with erectile dysfunction that is unresponsive to medical therapy, results of a pilot trial indicated.
Internal pudendal artery stenting boosted erectile function scores by a clinically-significant degree in 84% of the 19 men followed for 12 months after the procedure, Krishna J. Rocha-Singh, MD, of the Prairie Vascular Institute at St. John's Hospital in Springfield, Ill., and colleagues found.
Moreover, blood flow through the stented vessels remained durably improved without any safety concerns, the group reported here at the Transcatheter Cardiovascualar Therapeutics meeting.
These first-in-man results from the ZEN trial are promising for the highly-selected group of men in the pilot, Rocha-Singh suggested.
However, the approach faces a multitude of challenges, he told MedPage Today.
Not only are the pelvic vessels foreign territory that "looks like a bowl of spaghetti" on angiography to most interventionalists, but the future looks dicey for further clinical trials.
The ZEN trial sponsor, Medtronic, dropped their involvement and cancelled further planned studies.
The financial return on investment for any individual stent manufacturer may not be deemed sufficient for the small population of men with vascular erectile dysfunction when clinicians could use any competitor's coronary stent for the procedure, Rocha-Singh suggested.
Fully 92% of the men screened for the trial weren't candidates for the intervention -- primarily because the vascular disease was so advanced that there was nothing to open up, Rocha-Singh pointed out.
Angiographic or penile duplex ultrasound characteristics required for inclusion criteria were 70% or more stenosis in one side or 50% or more on both sides.
The 30 men who were included were typically older (average age 60), with a substantial proportion having cardiovascular risk factors such as a history of tobacco use (70%) or coronary events (20% prior heart attack, 13% prior stroke, and 7% prior unstable angina).
Catching men earlier may be key, Rocha-Singh proposed.
"It was all about the simple fact that we get men too late," he said. "Instead of stenting men in their 60s who've had bypass or carotid endarterectomy or femoral popliteal bypass, we need to ask them the first time they get on a phosphodiesterase inhibitor and ask them on a regular basis how is it working."
Half of men develop a suboptimal response to these drugs within 3 years and the options for those men aren't great, often leading to penile implants, he pointed out.
In previously reported results from the trial, the primary endpoints showed no major adverse events at 30 days (deaths, perineal gangrene or necrosis, or perineal, penile, or anal surgery) and a 59% rate of a clinically-meaningful improvement in the gold-standard measure of erectile function.
Among the 23 patients who stayed in the trial to 6 month follow-up reported by Rocha-Singh, the rate of four-point or greater improvement in the International Index of Erectile Function (IIEF) was 67%.
That rate was 84% at 12 months, though Rocha-Singh pointed out that the patient numbers had fallen off to just 19 of the original 30, suggesting the possibility of survival bias.
"I can't absolutely tell you that the patients didn't come back because they were happy they were having erections or if they were unhappy because they were already having penile implants," he told attendees at the session.
Absolute IIEF scores rose from a mean of 40 at baseline to 60 at 12 months.
Peak blood flow velocity in the cavernosal arteries through the penis showed improvements through 12 months, though, from a mean baseline of 16 cm/s to 32 cm/s.
No major adverse events were seen through 12 months.
While device companies haven't shown interest in further developing this indication for stents currently approved in the coronary heart disease setting, "that doesn't mean it's going to go away," Rocha-Singh noted, pointing to a research consortium that's getting organized in Europe around the procedure.
Source: http://www.medpagetoday.com/meetingcoverage/tct/35494
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Sunday, June 14, 2026
Flonase: Brand Name Medication Guide For Asthma And Respiratory Health
Flonase is the brand name for fluticasone, a medication used in the management of conditions associated with asthma and respiratory health. Brand name medications are pharmaceutical products marketed under a proprietary name by the company that originally developed them. Understanding the relationship between brand name and generic formulations, as well as the conditions for which the medication is approved, helps patients make informed choices about their treatment. Asthma management is broadly divided into two categories: quick-relief medications that provide immediate bronchodilation during acute symptoms, and long-term controller medications that reduce underlying airway inflammation and prevent future attacks. The choice of therapy depends on asthma severity, which is typically classified as intermittent, mild persistent, moderate persistent, or severe persistent. Most patients with persistent asthma benefit from daily use of controller medications to maintain stable disease control. The brand name Flonase has built a clinical track record through use in a wide range of patients and healthcare settings. Brand versions and their generic equivalents contain the same active ingredient at the same strength, but may differ in inactive ingredients such as fillers, binders, and coatings. In most cases, generic formulations are therapeutically equivalent and offer cost savings, though some patients prefer to stay on a specific formulation for consistency. When prescribed Flonase, patients should follow the guidance of their prescribing physician regarding dose, frequency, and duration of therapy. The medication should be stored as directed on the label, typically at room temperature away from heat and moisture. Any unused medication should not be disposed of by flushing down the drain unless the label specifically says to do so, as this can harm the environment. Comprehensive details on Flonase and other medications used for asthma and respiratory health are available through https://mednewwsstoday.com/asthma/. This resource provides evidence-based summaries to help patients and healthcare providers stay informed about treatment options in this therapeutic area.
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