Percutaneous Anterograde Varicocele Embolization: Technique and Clinical Outcomes

Transcatheter retrograde testicular vein embolization for symptomatic varicoceles is well-established but has a documented failure rate. Percutaneous anterograde varicocele embolization may be a suitable alternative. A retrospective observational, descriptive study of consecutive patients who had undergone unsuccessful retrograde embolization attempts underwent percutaneous anterograde varicocele embolization at a single center was performed. Twenty patients (16 adults and 4 adolescents) underwent unilateral varicocele treatment. Technical success rate was 100%. Mean fluoroscopy time was 106.5 seconds (SD ± 24.9). For patients treated for subfertility, mean DNA fragmentation index significantly decreased from 29.4% (SD ± 4.5%) to 22.0% (SD ± 2.5%) preprocedurally and postprocedurally, respectively. No clinical or radiologic evidence of varicocele recurrence was detected at 1- and 2-year follow-up. Four patients (20%) experienced self-limiting pain. No major adverse events occurred. Percutaneous anterograde varicocele embolization appears to be safe with high technical and clinical success rates. Radiation dose may be lower than that with retrograde embolization.