Percutaneous Anterograde Varicocele Embolization: Technique and Clinical Outcomes

Area of Science:

• Interventional Radiology
• Urology
• Male Infertility

Background:

• Transcatheter retrograde testicular vein embolization is a standard treatment for symptomatic varicoceles.
• This established method has a known failure rate, necessitating alternative approaches.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous anterograde varicocele embolization.
• To assess outcomes in patients with prior failed retrograde embolization attempts.

Main Methods:

• Retrospective observational study of 20 patients (16 adults, 4 adolescents) undergoing unilateral varicocele treatment.
• Percutaneous anterograde embolization was performed in patients with unsuccessful retrograde attempts.
• Follow-up included clinical, radiological assessment, and sperm DNA fragmentation index measurement.

Main Results:

• 100% technical success rate with no varicocele recurrence at 1- and 2-year follow-up.
• Significant reduction in mean sperm DNA fragmentation index (29.4% to 22.0%) in subfertile patients.
• Low complication rate, with 20% experiencing self-limiting pain; no major adverse events.

Conclusions:

• Percutaneous anterograde varicocele embolization is a safe and effective treatment option.
• The procedure demonstrates high technical and clinical success rates.
• Potential for reduced radiation exposure compared to retrograde embolization.