The results of selective phlebography of the spermatic vein are reported in 580 infertile men with abnormal sperm morphology and suspected varicoceles. Percutaneous transvenous retrograde sclerotherapy of the internal spermatic vein was performed in 260 of the patients. Follow-up phlebography in 109 patients 3 to 6 months after treatment revealed a persistent varicocele in only 3% of them.

Sclerosis of the spermatic vein for male infertility and varicoceles was carried out in 84 patients by a percutaneous method. If the catheter is correctly placed in the spermatic vein, sclerosis is possible in almost all cases, as was shown by controlled examinations after periods of more than three months. Together with the radiologic changes, there was also an improvement in the spermatologic parameters. 58% of the patients examined after three months were regarded as fertile.

We evaluated the diagnostic accuracy and complications of digital subtraction angiography (DSA) in a series of clinical trials conducted on patients primarily with cerebral vascular disease and those evaluated before and after surgery or percutaneous transluminal angioplasty. Double-blind studies of the carotid-vertebral arteries of 300 of the 2,200 patients using DSA imaging and a variety of ionic and nonionic contrast agents showed that although subjects tolerated the injection of nonionic contrast better than ionic, nonionic contrast administration did not lead to better image quality. Of 764 patients receiving ionic contrast media, 3.3% had mild-to-serve adverse reactions; of 350 injected with nonionic contrast agents, 1.7% had mild-to-severe adverse reactions. If the sole consideration is safety, use of ionic contrast media is justified.

The results of selective phlebography of the spermatic vein in patients with primary sterility and suspected varicoceles are reported. In 60% of those examined there was left-sided, and in 8.8% right-sided, spermatic vein insufficiency or a varicocoele. The value of spermatic vein phlebography is borne out by the large number of anomalies of the venous system (67%) and by the finding of 82 left-sided varicoceles.

Digitalised video subtraction angiography permits the demonstration of arteries in the trunk by means of intravenous injection. Initial experience with 120 examinations has demonstrated its usefulness for showing the arteries in the neck, the aorta, the renal arteries, pelvic arteries and arteries in the thigh in between 80 and 90% of cases. Use of the technique during arterial arteriography avoids the need for photographic subtraction and permits a reduction of contrast volume and flow rate. Further clinical experience will be necessary in order to determine the value of the technique.