Figure 1
Fluoroscopy image showing selective catheterization of an insufficient left ISV during Valsalva manoeuvre before embolization (A), noting dilated veins in the pampiniform plexus (arrows) and the presence of a collateral vein (arrowheads). Fluoroscopy image showing a sandwich coil embolization at two levels of the left ISV (arrows) resulting in a complete stasis of contrast media at the proximal level (B).
Table 1
Laterality of varicocele and relative technical success rates.
| LEFT‑SIDED | RIGHT‑SIDED | TOTAL | |
|---|---|---|---|
| Number (n), (percentage [%]) | 179 (77.92%) | 32 (22.08%) | 211 (100%) |
| Technical success, n (%) | 167 (93.27%) | 19 (59.37%) | 186 (88.15%) |
Figure 2
Box and whisker plot for pain VAS before and after the intervention.
VAS = Visual Analog Scale.
Figure 3
Flow chart of patients who underwent varicocele embolization for scrotal pain.
Green = clinical success. Red = clinical failure.
Table 2
Mean values of duration of fluoroscopy, DAP and KERMA for the 71 interventions performed with coils and by right femoral access point.
| DURATION OF FLUOROSCOPY (MIN) | DAP (GY∙CM²) | KERMA (MGY) | |
|---|---|---|---|
| Median [IQR] | 17.1 [10, 24.3] | 43.1 [30.8, 94.1] | 130.4 [88.2, 254] |
| Mean ± SD | 20.3 ± 14.9 | 63.2 ± 50.5 | 193.2 ± 173.6 |
| Mean (95% CI) | 20.3 [17.1, 23.6] | 63.2 [52.1, 74.2] | 193.2 [155.3, 231.2] |
[i] DAP = dose area product; KERMA = kinetic energy released per unit mass; IQR = interquartile range; SD = standard deviation; CI = confidence interval.
Table 3
Table summarizing different studies with employed embolic agents, venous access points, laterality of varicocele in patients and technical success rates.
| STUDY | EMBOLIC AGENT (N) | VENOUS ACCESS POINT | VARICOCELE LATERALITY (N) | TECHNICAL SUCCESS RATE |
|---|---|---|---|---|
| Prasivoravong et al. [14] (2014) | Coils | Femoral | Left (47) | 100% |
| Cantoro et al. [18] (2015) | Coils | Femoral | Left (218) | 89% |
| Nabi et al. [19] (2003) | Coils | Femoral | Left (50) Right (15) Bilateral (6) | 96% |
| Shlansky‑Goldberg et al. [20] (1997) | Coils | Femoral or jugular | Left (95) Right (15) Bilateral (63) | 88% |
| Bilreiro et al. [21] (2017) | Coils (103) Glue (26) | Femoral | Left (129) | 99% (coils) 100% (glue) |
Table 4
Table reviewing different studies of varicocele embolization, reporting clinical success or recurrence rates in patients referred for scrotal pain, with follow‑up durations and definitions of the studied entities.
| STUDY | FOLLOW‑UP DURATION (MONTHS) | STUDIED ENTITY | DEFINITION | RATE |
|---|---|---|---|---|
| Bilreiro et al. [21] (2017) | 10–36 (range) | Clinical success | Complete absence of symptoms | 4/6 (66.67%) for glue |
| 30/34 (88.24%) for coils | ||||
| Recurrence | Dilated pampiniform plexus veins (calibre >3 mm) in a supine position with reflex (with/without Valsalva manoeuvre) | 3/26 (11.54%) for glue | ||
| 6/103 (5.83%) for coils | ||||
| Favard et al. [8] (2015) | 24.4 ± 17 (mean ± SD) | Clinical success | Absence of reflux on Doppler ultrasound examination and/or absence of scrotal pain and heaviness depending on the initial indication | 83.9% |
| Recurrence | Varicocele which required a new endovascular or surgical repair | 7/63 (11%) for glue | ||
| 7/53 (13.2%) for mechanical agents | ||||
| 4/66 (6%) for sclerosing agent | ||||
| Puche‑Sanz et al. [6] (2014) | 39 (median) | Clinical success | Patients who completely improved or partially improved but appeared significantly satisfied | 86.9% for coils |
| Recurrence | Persistence of venous reflux on ultrasonography | 13.1% for coils | ||
| Sheehan et al. [5] (2020) | 58 (median) (range, 28–106) | Recurrence | Recurrence of testicular pain in the presence of a varicocele | 7/71 (16%) for glue and coils |