Pudendal Atherosclerosis by IVUS-NIRS in Men With Coronary Artery Disease (PUDENDAL-NIRS)

September 30, 2026 updated by: Hospital Central Militar

Characterization of Internal Pudendal Atherosclerosis by Intravascular Ultrasound and Near-Infrared Spectroscopy and Its Relationship With Erectile Dysfunction in Men With Coronary Artery Disease

This prospective, single-center, exploratory study will evaluate the association between atherosclerotic and lipid plaque burden in the internal pudendal arteries, assessed by intravascular ultrasound and near-infrared spectroscopy (IVUS-NIRS), and the severity of erectile dysfunction in adult men with documented or suspected coronary artery disease undergoing clinically indicated coronary angiography.

After completion of the clinically indicated coronary procedure, eligible and hemodynamically stable participants with favorable pelvic vascular anatomy will undergo selective pudendal angiography and investigational IVUS-NIRS imaging of one or both internal pudendal arteries. Erectile function will subsequently be assessed within 30 days using the 5-item International Index of Erectile Function (IIEF-5).

The primary outcome will be the correlation between pudendal maxLCBI4mm and IIEF-5 score. Secondary analyses will characterize pudendal and coronary plaque burden, assess the relationship between pudendal and coronary lipid burden, evaluate associations with cardiovascular risk factors, and describe the technical feasibility and safety of pudendal IVUS-NIRS imaging.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Mexico City
      • Mexico City, Mexico City, Mexico, 11200
        • Recruiting
        • Hospital Central Militar
        • Contact:
        • Contact:
        • Principal Investigator:
          • José Raúl Méndez Colin, MD
        • Sub-Investigator:
          • Luis Enrique Berumen Domínguez, MD
        • Sub-Investigator:
          • José Gadú Campos Salcedo, MD
        • Sub-Investigator:
          • Edwin García Sánchez, MD
        • Sub-Investigator:
          • Luis David Sánchez Mayo, MD
        • Sub-Investigator:
          • Aldo Figueroa Peña, MD
        • Sub-Investigator:
          • María Ximena Romo Cordero, MD
        • Sub-Investigator:
          • Roberto Paniagua Jiménez, MD
        • Sub-Investigator:
          • Eduardo Sánchez Cortés, MD
        • Sub-Investigator:
          • Ángel Leovigildo Alberto Delgado, MD
        • Sub-Investigator:
          • Alfredo Andrei Tort Hidalgo, MD
        • Sub-Investigator:
          • Cesar Gerardo Galván Vargas, MD
        • Sub-Investigator:
          • Mario Humberto Lozano Quintas, MD
        • Sub-Investigator:
          • Jorge Alberto Silva Rendón, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

Inclusion Criteria:

  1. Male participants aged 18 years or older.
  2. Documented or suspected coronary artery disease with a clinical indication for coronary angiography.
  3. Coronary IVUS-NIRS evaluation indicated by the treating interventional cardiologist.
  4. Sufficient clinical and hemodynamic stability to undergo the additional pudendal evaluation.
  5. Favorable pelvic vascular anatomy for selective angiography and safe advancement of the IVUS-NIRS catheter.
  6. Ability to complete the IIEF-5 questionnaire and provide information regarding sexual function.
  7. Written informed consent specifically for study participation and invasive evaluation of the internal pudendal arteries.
  8. Agreement to clinical follow-up by Cardiology and Urology.

Exclusion Criteria:

  1. Cardiogenic shock, hemodynamic instability, or acute clinical deterioration.
  2. Urgent or complicated coronary procedure in which prolonging the procedure would increase risk.
  3. Advanced kidney disease or high risk of kidney injury associated with additional contrast administration.
  4. Unfavorable iliofemoral or pelvic vascular anatomy for safe evaluation of the internal pudendal arteries.
  5. Severe coagulopathy, active bleeding, or contraindication to the invasive procedure.
  6. History of radical pelvic surgery or pelvic radiotherapy.
  7. Advanced prostate cancer or previous urologic treatment that predominantly explains erectile dysfunction.
  8. Severe untreated hypogonadism, advanced neurologic disease, or another predominant nonvascular cause of erectile dysfunction.
  9. Inability to reliably complete the IIEF-5 questionnaire.
  10. Refusal to participate or to provide study-specific written informed consent.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Pudendal IVUS-NIRS Evaluation

Participants will undergo selective angiography of the internal iliac and internal pudendal arteries followed, when technically feasible and clinically safe, by investigational IVUS-NIRS imaging of one or both internal pudendal arteries.

Selective angiography of the internal iliac and internal pudendal arteries will be performed after completion of the clinically indicated coronary procedure to assess pelvic vascular anatomy and technical feasibility for intravascular imaging.

When vascular anatomy and clinical conditions are considered suitable, an IVUS-NIRS catheter will be advanced into one or both internal pudendal arteries. Automated pullback imaging will be performed to assess vessel anatomy, plaque burden, lipid core burden index (LCBI), and maxLCBI4mm.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation Between Pudendal maxLCBI4mm and IIEF-5 Score
Time Frame: At the pudendal IVUS-NIRS procedure and within 30 days after enrollment for IIEF-5 assessment

The association between the maximum lipid core burden index within a 4-mm segment (maxLCBI4mm) of the internal pudendal arteries, measured by IVUS-NIRS, and erectile function assessed by the 5-item International Index of Erectile Function (IIEF-5) will be evaluated using Spearman correlation. Pudendal maxLCBI4mm ranges from 0 to 1000, with higher values indicating greater lipid burden. IIEF-5 scores range from 5 to 25, with lower scores indicating more severe erectile dysfunction.

At the pudendal IVUS-NIRS procedure and within 30 days after enrollment for IIEF-5 assessment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pudendal Artery Plaque Burden by IVUS
Time Frame: During the pudendal IVUS-NIRS procedure

Pudendal artery plaque burden will be quantified by intravascular ultrasound (IVUS) as the proportion of the vessel area occupied by plaque plus media. Measurements will include plaque burden, minimum lumen area, and angiographic percent stenosis in the evaluated internal pudendal arteries.

During the pudendal IVUS-NIRS procedure
Pudendal Artery Lipid Burden by NIRS
Time Frame: During the index pudendal IVUS-NIRS procedure

Lipid burden in the internal pudendal arteries will be characterized using near-infrared spectroscopy (NIRS), including the Lipid Core Burden Index (LCBI) and maximum LCBI within any continuous 4-mm segment (maxLCBI4mm). If both internal pudendal arteries are evaluated, measurements from each side will be recorded and the highest maxLCBI4mm per participant will be used for the main analyses.

During the index pudendal IVUS-NIRS procedure
Correlation Between Pudendal and Coronary maxLCBI4mm
Time Frame: During the index coronary and pudendal IVUS-NIRS procedures

The association between pudendal and coronary lipid burden will be assessed by correlating the highest pudendal maxLCBI4mm with the highest coronary maxLCBI4mm obtained by IVUS-NIRS. The correlation will be evaluated using Spearman correlation.

During the index coronary and pudendal IVUS-NIRS procedures
Pudendal Atherosclerotic and Lipid Burden According to Erectile Dysfunction Severity
Time Frame: Within 30 days after enrollment

Pudendal atherosclerotic and lipid burden, including plaque burden and maxLCBI4mm, will be compared across erectile dysfunction severity categories defined by the IIEF-5 score: no erectile dysfunction, mild, mild-to-moderate, moderate, and severe erectile dysfunction.

Within 30 days after enrollment
Spearman Correlation Between Pudendal maxLCBI4mm and LDL Cholesterol
Time Frame: At baseline

Spearman's rank correlation coefficient (rho) will be calculated between pudendal maxLCBI4mm measured by near-infrared spectroscopy (NIRS) and serum low-density lipoprotein cholesterol (LDL-C). Pudendal maxLCBI4mm is expressed as an index from 0 to 1000, with higher values indicating greater lipid burden. LDL-C is expressed in mg/dL.

At baseline
Number of Participants With Successful Pudendal IVUS-NIRS Image Acquisition
Time Frame: Periprocedural

The number of participants in whom analyzable IVUS-NIRS images are successfully obtained from at least one internal pudendal artery will be reported. Successful image acquisition is defined as acquisition of images of sufficient quality for quantitative IVUS and NIRS analysis.

Periprocedural
Procedure-Related Adverse Events
Time Frame: From the pudendal procedure through the 30-day study evaluation

Adverse events related to selective pudendal angiography and IVUS-NIRS imaging will be recorded, including arterial dissection, perforation, persistent vasospasm, thrombosis, bleeding, contrast-associated kidney injury, embolization, or other complications considered attributable to the investigational pudendal procedure.

From the pudendal procedure through the 30-day study evaluation

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: José Raúl Méndez Colin, MD, Hospital Central Militar
  • Study Director: Luis Enrique Berumen Domínguez, MD, Hospital Central Militar

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 24, 2026

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

September 25, 2026

First Submitted That Met QC Criteria

September 30, 2026

First Posted (Actual)

October 2, 2026

Study Record Updates

Last Update Posted (Actual)

October 2, 2026

Last Update Submitted That Met QC Criteria

September 30, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because the study protocol and informed consent do not include a plan for external sharing of participant-level data. Study data will remain under institutional custody and will be used for the approved research objectives, analyses, and scientific publications while maintaining participant confidentiality.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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