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Selective spermatic venography and varicocele embolization in men with circumaortic left renal veins
Kiang-Hiong Tay1, Michael L Martin, A Lisl Mayer
1Department of Radiology, University of British Columbia, UBC Hospital, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada.
Insights
Percutaneous varicocele embolization is feasible in men with circumaortic left renal veins. This variant anatomy requires familiarity with jugular and femoral venous approaches for successful selective catheterization and embolization.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Urology
Background:
- Variant venous anatomy, such as circumaortic left renal veins, can complicate percutaneous procedures.
- Percutaneous varicocele embolization is a standard treatment for varicoceles.
Purpose of the Study:
- To review the technical feasibility and outcomes of percutaneous varicocele embolization in patients with circumaortic left renal veins.
Main Methods:
- Retrospective review of 18 men with circumaortic left renal veins undergoing left spermatic venography and embolization.
- Utilized both jugular and femoral venous access for selective catheterization.
Main Results:
- Successful selective left spermatic vein catheterization in 17 out of 18 patients.
- All patients with positive venographic findings underwent successful embolization.
- Variable confluence sites of the left spermatic and renal veins were noted.
Conclusions:
- Percutaneous varicocele embolization is technically feasible in the presence of circumaortic left renal veins.
- Familiarity with venous anatomic variations and dual venous access routes is crucial for successful outcomes.
Abstract:
The presence of variant venous anatomy may increase the technical difficulty of percutaneous varicocele embolization. The authors review their experience performing venography of the left spermatic vein and varicocele embolization in 18 men with circumaortic left renal veins. Selective catheterization of the left spermatic vein was achieved in all but one patient, and all patients with positive venographic results underwent successful embolization. The site of the confluence of the left spermatic vein and the renal vein was variable and it was necessary to use jugular and femoral venous approaches to achieve selective left spermatic vein catheterization. Familiarity with anatomic variations associated with circumaortic renal veins and with embolization techniques from jugular and femoral venous routes facilitates percutaneous varicocele embolization in patients with this variant.