Radiation Exposure during Varicocele Embolization: Does Access Site and Treated Side Matter?

Abstract

The purpose of the study was to evaluate radiation exposure during varicocele embolization and correlate it with access site, embolized side, and complexity of varicoceles. Materials and Methods: This retrospective study included 39 adults who underwent varicocele embolization with a combination of coils and sclerosing agents between January 2015 and December 2018. Left-sided embolization was done in 26 patients and bilateral embolization in 13 patients. Jugular access was used in ten patients, whereas upper limb access was done in 29 patients. Dose area product (DAP) and total fluoroscopy time were collected and correlated to the treated side, access site, and complexity of varicoceles. Results: The mean fluoroscopy time for left varicocele embolization was 26.76 min, which was not statistically different (P = 0.16) compared to bilateral embolization (33.2 min). There was no statistical difference (P = 0.37) between the mean DAP for left embolization of 106,239 mGy.cm² compared to bilateral DAP of 107,153 mGy.cm². There was no difference in the mean DAP or fluoroscopy time between jugular vein access (DAP = 87,569 mGy. cm², time = 34 min) and upper limb venous access (DAP = 113,086.8534 mGy.cm², time = 28 min) with P = 0.64 and P = 0.14, respectively. There was no statistically significant correlation between the left varicocele Bähren classification and the fluoroscopy time (P = 0.52) or DAP (P = 0.76). Conclusion: This study finds no significant difference in DAP or fluoroscopy time between jugular and upper limb venous access or between left and bilateral embolization.