title: Ethylene-vinyl alcohol copolymer (Onyx(®)) transarterial embolization for post-traumatic high-flow priapism.
abstract: We report a case of high-flow priapism treated successfully with superselective embolization of the cavernous artery. A 16-year-old male developed post-traumatic priapism subsequent to a fall causing blunt perineal trauma. He presented to our hospital four days after trauma. Immediately after the injury, he suffered painless sustained incomplete erection. High-flow priapism was diagnosed on the basis of color doppler ultrasonography findings. Computed tomography scan showed a high-flow arterio-venous fistula with feeders from branches of the right internal iliac artery. Selective arteriography of the right internal pudendal artery demonstrated an arterio-cavernous fistula. The fistula was superselectively embolized with ethylene-vinyl alcohol copolymer (Onyx(®)) liquid agent and disappeared completely. Improvement was noted, with significant detumescence on table. This was later confirmed on repeat color Doppler imaging. At follow-up 3 months later, he had normal erectile function. To our knowledge, transarterial embolization of high-flow priapism with Onyx(®) has never been reported and appears to be a safe and effective treatment for managing patients with such a condition.
authors.affiliation: Department of Vascular, Oncologic and Interventional Radiology, Arts et Métiers, University of Burgundy, François-Mitterrand Teaching Hospital, Dijon, France ;
authors.forename: Olivier
authors.initials: O
authors.lastname: Chevallier
authors.affiliation: Department of Vascular, Oncologic and Interventional Radiology, Arts et Métiers, University of Burgundy, François-Mitterrand Teaching Hospital, Dijon, France ;
authors.forename: Sophie
authors.initials: S
authors.lastname: Gehin
authors.affiliation: Department of Urological Surgery, Urology Private Center, Dijon, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Foahom-Kamwa
authors.affiliation: Department of Vascular, Oncologic and Interventional Radiology, Arts et Métiers, University of Burgundy, François-Mitterrand Teaching Hospital, Dijon, France ;
authors.forename: Pierre
authors.initials: P
authors.lastname: Pottecher
authors.affiliation: Department of Vascular, Oncologic and Interventional Radiology, Arts et Métiers, University of Burgundy, François-Mitterrand Teaching Hospital, Dijon, France ;
authors.forename: Sylvain
authors.initials: S
authors.lastname: Favelier
authors.affiliation: Department of Vascular, Oncologic and Interventional Radiology, Arts et Métiers, University of Burgundy, François-Mitterrand Teaching Hospital, Dijon, France ;
authors.forename: Romaric
authors.initials: R
authors.lastname: Loffroy
keywords: High-flow priapism; computed tomography; ethylene-vinyl alcohol copolymer; transarterial embolization