Selective intra-arterial angiogram (acquired with Artis Q angiography system) of the left pudendal internal artery showing a tandem lesion distally (arrows).
A 56-year-old male presented for vascular workup of erectile dysfunction (ED). He complained of a massive reduction in his penile rigidity leading to an inability to have sexual intercourse for the last 2 years despite the use of phosphodiesterase-5 inhibitors (Viagra). A workup with an urologist delivered no specific pathological findings and his testosterone levels were normal. His cardiovascular risk factors included cigarette smoking (40 pack years).
Download the full clinical case here.