Percutaneous Embolotherapy of Adolescent Varicocele: Results and Long-term Follow-up

Reyes, Benedicto L.; Trerotola, Scott O.; Venbrux, Anthony C.; Savader, Scott J.; Lund, Gunnar B.; Peppas, Dennis S.; Mitchell, Sally E.; Gearhart, John P.; White, Robert I.; Osterman, Floyd A.

doi:10.1016/s1051-0443(94)71469-x

Cited by 50 publications

(26 citation statements)

References 13 publications

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“…Reyes et al [8] reported 7% recurrence rate in a group of 59 children with a median 4 year FU. Other authors did not differentiate failure from recurrence in their studies: Alqahtani et al [4] reported 10% failure and recurrence rate in a group of 41 adolescents with median 22 month FU, whereas, Sivanathan et al [10] observed a pretty disappointing 35% failure and relapse rate with median 13 month FU.…”

Section: Discussionmentioning

confidence: 96%

“…With interventional radiology techniques-initially proposed by Iaccarino in 1977 [6]-a sclerosing substance, either alone or associated with the placement of detachable balloons or coils, is injected in the spermatic vein with a retrograde approach after percutaneous catheterization of the femoral [7] or brachial vein [8] under local anesthesia.…”

Section: Introductionmentioning

confidence: 99%

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Retrograde percutaneous sclerotherapy of left idiopathic varicocele in children: results and follow-up

et al. 2008

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Treatment of pediatric patients with varicocele is based on the desire to prevent testicular dysfunction and possible infertility that may become irreversible in adults. The authors reviewed their experience with retrograde percutaneous sclerotherapy (RPS) via a trans-femoral approach to assess its results in children. A retrospective study was conducted, including all the children admitted between 2000 and 2004 who underwent RPS with at least 24 months follow-up (FU). The indication for treatment was grade II and III varicocele (Dubin-Amelar classification), confirmed by Doppler US. Three per cent sodium tetradecyl sulfate was the sclerosing agent. FU included Doppler US 1 month after the procedure and then yearly for at least 2 years. Eighty-six children (mean age 13.8 years) underwent phlebography and, when feasible, RPS. Varicocele was grade II in 49 cases and grade III in 37. RPS was feasible in 72 (84%) children because of unfavourable anatomic features of the left spermatic vein. RPS was successful in 66 (92%) out of 72 treated children. Median FU was 29 months. During FU, five (8%) patients relapsed. RPS of varicocele is a simple and effective treatment. A minimum of 2 years FU is recommended, as a few cured cases may relapse during this period.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Retrograde percutaneous sclerotherapy of left idiopathic varicocele in children: results and follow-up

et al. 2008

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“…Embolic agents can be directly delivered through the diagnostic catheter or in a coaxial way through a microcatheter. The procedure is performed on an outpatient basis under local anesthesia on a tilted X-ray table [17][18].…”

Section: Percutaneous Endovascular Occlusionmentioning

confidence: 99%

“…Balloons are frequently used in combination with other agents like coils or with sandwiched 70% dextrose (a sclerosing agent) [17]. Varicocele treatment with coils was introduced by Thelen, et al who used the original 0.038-inch Gianturco coils [30].…”

Section: Non-liquid Embolicsmentioning

confidence: 99%

Contribution to the Pathophysiology and Treatment of Varicoceles

Vanlangenhove¹

2018

Journal of the Belgian Society of Radiology

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Anatomical differences between adults and adolescents and between left and right varicoceles were shown in this work. We designed a standardized and reproducible method for pressure measurement in the inguinal internal spermatic vein (ISV). We demonstrated that the mean absolute pressure in the ISV in the upright position is higher than the veno-capillary pressure in the testicle, and hence could impair spermatogenesis prompting the need for treatment in varicoceles.Histoacryl transparent and Glubran2, the current commercially available adhesives for the treatment of varicoceles, do not differ with regard to efficiency, safety and tolerance during and after embolization. Both adhesives cause a mild pain in 30% of the patients in the week after embolization. The radiation exposure is low during embolizations of varicoceles with highly viscous liquid products. Therefore, the endovascular treatment with glue is an efficient, safe and tolerable method of treatment for varicoceles when applicable. Keywords: Varicocele; Embolization; Glue IntroductionThis thesis aimed at contributing to the pathophysiology and treatment of varicoceles. The research project encompasses five prospective studies and one retrospective study. The specific objectives of these clinical studies were to assess: (i) the safety, efficacy and tolerance of two types of glue and a non-gluing liquid embolic agent, in the endovascular treatment of varicoceles, (ii) to assess radiation burden for patient during varicocele embolization, (iii) to develop a standardized method to read the phlebographic anatomy of varicoceles and to test a different ontogenesis of varicoceles in adolescents and adults, and (iv) lastly to develop a standardized method to measure the intravascular pressure in the internal spermatic vein and to determine whether infertility in varicoceles can be explained by the principle of elevated hydrostatic pressure.

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“…This can be achieved by surgical or percutaneous endovascular techniques. Percutaneous embolization has the advantage of being an outpatient procedure with a faster return to normal activities with a considerable lower cost and lower recurrence rate than surgery [10][11][12]. Embolization materials, such as stainless steel coils, detachable balloons, or sclerosal agents were used [13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Two Different n-Butyl-2-Cyanoacrylates for the Embolization of Varicoceles: A Prospective, Randomized, Blinded Study

Vanlangenhove

Keukeleire

Everaert

et al. 2011

Cardiovasc Intervent Radiol

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Percutaneous Embolotherapy of Adolescent Varicocele: Results and Long-term Follow-up

Cited by 50 publications

References 13 publications

Retrograde percutaneous sclerotherapy of left idiopathic varicocele in children: results and follow-up

Retrograde percutaneous sclerotherapy of left idiopathic varicocele in children: results and follow-up

Contribution to the Pathophysiology and Treatment of Varicoceles

Efficacy and Safety of Two Different n-Butyl-2-Cyanoacrylates for the Embolization of Varicoceles: A Prospective, Randomized, Blinded Study

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