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Updated: Jun 8, 2026
Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
Long-term efficacy and catheter choice in male varicocele embolization using NBCA-MS glue
Ezio Lanza1,2, Alessandra Mininni1,2, Luigi Tomasino1,2
1Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
Purpose:
This study investigated the long-term efficacy of n-butyl-2-cyanoacrylate-metacryloxysulpholane (NBCA-MS) for varicocele embolization (VE) without using a microcatheter.
Methods:
A retrospective study was conducted on male patients who underwent VE with NBCA-MS for grade III-IV varicocele between January 2016 and December 2022. Patients were categorized by the catheter type used. Telephone interviews assessed long-term effectiveness, focusing on relapse, re-treatment and spermiogram improvements.
Results:
Of 185 patients, 102 completed the phone interview (median age 25 years, median follow-up 4.1 years). Sixty-six procedures were performed with only an HH1 catheter (Group A, 65%), and 36 required an additional microcatheter (Group B, 35%), with Group A having a shorter median procedure time (30 vs. 36.5 min, p = 0.004). Long-term follow-up indicated a low recurrence rate (12%) and spermiogram improvement among a subset of patients (81%), with no significant difference in long-term efficacy between groups (relapse p = 0.244, re-treatment p = 1). Costs increased by 47-56% when adding a microcatheter plus a 0.018-inch guidewire.
Conclusion:
The study confirms the effectiveness and safety of VE with NBCA-MS, demonstrating low recurrence rates and improvements in groin discomfort and fertility outcomes. In most cases of varicocele embolization using NBCA-MS, microcatheters can be avoided, reducing procedural costs and duration without compromising long-term efficacy.
