Percutaneous spermatic vein occlusion: evaluation of sclerosing agents in experimental animals

The 5%-20% rate of recurrence of testicular varicoceles after embolotherapy has been a persistent clinical problem. Three sclerosing agents--sodium tetradecyl sulfate 3%, absolute ethanol, and 100 degrees C contrast material--were evaluated in canine spermatic veins for degree and durability of venous occlusion. Pathologic examination for perivenous, pulmonary, and neural changes was performed. Both sodium tetradecyl sulfate and absolute ethanol were effective sclerosants, but sodium tetradecyl sulfate was technically easier to use. The use of a sclerosant in conjunction with balloons or coils is the safest, most effective technique for occluding variococeles and minimizing postembolotherapy recurrences.