Left spermatic vein retrograde sclerosis: comparison between sclerosant agent injection through a diagnostic catheter versus through an occluding balloon catheter

Basile, Antonio; Failla, Giovanni; Vignera, Sandro La; Condorelli, Rosita A.; Calogero, Aldo E.; Vicari, Enzo; Granata, Antonio; Mundo, Elena; Caltabiano, Giuseppe; Pizzarelli, Marco; Messina, Martina; Scavone, Giovanni; Lanzafame, Franz; Iezzi, Roberto; Tsetis, Dimitrios

doi:10.1007/s11547-014-0478-9

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…Foam sclerotherapy has been considered to offer several advantages over traditional liquid sclerotherapy [57]. The foam has the advantage of a better distribution of the sclerosing agent on the endothelial surface and of multiple collateral branches, resulting in a more effective embolization [69].…”

Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

“…The sclero-embolization technique consists of injecting a sclerosing agent, as a pure liquid or mixed with air as foam, into the distal portion of the ISV [15,25,45,69]. The sclerosing agent is prepared in foam by mixing the contents of two syringes, one containing the sclerosing agent and the other containing unfiltered room air, according to Tessari et al [70]; some authors use a ratio of 1:1 (air and sclerosing), adding 2 mL of contrast media to create the foam [25,45], others use 70% of sclerosing agent and 30% of air [69]. Before injecting the sclerosing agent, a distal barrage near the external inguinal ring is mandatory to prevent the agent from penetrating into the pampiniform plexus during Valsalva maneuver, hence avoiding inflammation and thrombosis (thrombophlebitis) of the pampiniform plexus; for this purpose, some authors place coils at the level of the inguinal canal [45], while others use manual compression [15] or rubber band applied at the highest level of the scrotum, kept in place for 10 min after sclerosing injection and then released [69].…”

Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

“…This technique, also known as "OB technique", refers to the use of a temporary proximal OB catheter in addition to distal barrage, to stop the retrograde blood flow: the sclerosing agent is injected through the OB catheter into the distal portion of the ISV without any Valsalva maneuver (Figure 4). Through the OB technique, the sclerosing agent becomes more controllable during its injection and remains in constant contact, at highest concentration, with the vessel walls [69].…”

Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

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Liquid and Solid Embolic Agents in Gonadal Veins

Tiralongo

Distefano

Palermo

et al. 2021

JCM

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Male varicocele and pelvic congestion syndrome (PCS) are common pathologies with high predominance in young patients, having a high impact on the quality of life and infertility. Lately, the use of different endovascular embolization techniques, with various embolizing agents, shows good technical results and clinical outcomes. With the aim of presenting the “state of the art” of endovascular techniques for the treatment of male varicocele and PCS, and to discuss the performance of the different embolic agents proposed, we conducted an extensive analysis of the relevant literature and we reported and discussed the results of original studies and previous meta-analyses, providing an updated guide on this topic to clinicians and interventional radiologists. We have also underlined the technical aspects for the benefit of those who approach this type of interventional treatment. Our review suggests promising results in both the endovascular embolic treatment of male varicocele and PCS; for varicocele, a success rate of between 70% and 100% and a recurrence rate of up to 16% is reported, while for PCS it has been found that technical success is achieved in almost all cases of endovascular treatment, with a highly variable recurrence rate based on reports. Complications are overall rather rare and are represented by periprocedural pain, migration of embolic media and vascular perforations: severe adverse events have been reported very rarely.

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Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

Section: 10 X For Peer Review 6 Of 21mentioning

confidence: 99%

See 2 more Smart Citations

Liquid and Solid Embolic Agents in Gonadal Veins

Tiralongo

Distefano

Palermo

et al. 2021

JCM

Self Cite

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“…A small amount of sclerosing agent ectopic embolization was also observed, which suggested that injecting the sclerosing agent through a balloon catheter might lead to a more complete embolization, with more advantages in controlling the sclerosing agent. 17 Previous data have shown that sclerosing agent injection resulted in lower incidence of complications compared to traditional surgery and laparoscopy. 18 Lymphatic ligation is considered to be an important reason for testicular function decline.…”

Section: Discussionmentioning

confidence: 99%

Analysis of internal spermatic vein embolization through catheter versus laparoscopic high ligation in treatment of left varicocele

et al. 2020

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Objective Varicocele is a common disease in young and middle-aged men. This study aims to compare the efficacy of internal spermatic vein embolization of left varicocele versus laparoscopic high ligation. Methods From January 2017 to September 2018, a total of 69 varicocele patients were admitted and given the opportunity to choose the treatment option. Among these, 26 patients were treated with sclerosing agent injection, while 43 patients underwent laparoscopic surgery. They were followed up for 12 months after surgery, and the technical success rate, recurrence rate, complication rate, cost, operative time, and hospitalization time with regard to these two methods were analyzed. Results All patients completed the medical procedures. There was no recurrence in patients in the sclerotherapy group during the follow-up period; however, the complication rate was 19.2%. Furthermore, the operative time, hospitalization time, and cost of treatment were 31.1 ± 11.1 min, 1.2 ± 0.49 days, and 9613.11 ± 895.97 Yuan, respectively. In the laparoscopic group, 9 patients underwent laparoscopic bilateral high ligation, while 34 patients received treatment on the left side alone. The recurrence rate of left varicocele was 4.7% and the complication rate was 44.2%. Furthermore, the operative time, hospitalization time, and treatment cost were 50.4 ± 14.48 min, 4.0 ± 2.02 days, and 10,948.29 ± 2547.00 Yuan, respectively. Moreover, there were statistically significant differences ( P < 0.05) in operative time, hospitalization time, and treatment cost. Patients in the sclerotherapy group had an advantage with respect to the overall complication rate when compared with patients from the laparoscopic group ( X2 = 4.448, P < 0.05), and there was a statistically significant difference in hydrocele ( X2 = 4.555, P < 0.05). However, there was no significant difference in the recurrence rate between these two groups ( X2 = 1.245, P > 0.05). Conclusion Patients who underwent sclerotherapy showed a higher technical success rate, a lower recurrence rate, fewer complications, and shorter hospitalization time compared to those treated with laparoscopic ligation. Transcatheter sclerosing agent injection may be a preferable treatment option for patients with unilateral varicocele.

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