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[Percutaneous sclerotherapy of a varicocele with atypical retrograde flow using a double-balloon occlusion technique]
C Nolte-Ernsting1, H Schubert, R W Günther
1Klinik für Radiologische Diagnostik, Universitätsklinikum der RWTH Aachen.
Objective:
To perform a double-balloon occlusion for selective sclerosis of the internal spermatic vein in a varicocele with atypical retrograde flow.
Method:
In a 19-year-old man with a primary varicocele, phlebography demonstrated an 8-mm-wide internal spermatic vein with parallel collaterals and marked reflux of the contrast agent in the supine position. A single balloon occlusion could not prevent rapid wash-out of contrast material via collateral veins. Subsequently, two 8-mm balloon-catheters were sequentially inserted into the internal spermatic vein. After inflation of both balloons, the sclerosing agent was administered through the proximal catheter into the balloon-occluded venous segment.
Result:
Percutaneous sclerotherapy using the double-balloon technique achieved complete stasis inside the ectatic and retrograde perfused spermatic vein including its major parallel collaterals.
Conclusion:
In primary varicocele with strong spontaneous reflux and complicated flow pattern of the collateral veins, the double-balloon occlusion technique can achieve high local concentration of the sclerosing agent at optimal position and without wash-out effects.