Abstract
We report a case of a 29-year-old male referred to our hospital for endovascular treatment of a left-sided painful varicocele. Standard retrograde embolization via the left renal vein was not possible because of the presence of a left circum-aortic renal vein making the catheterization of the testicular vein not feasible. The patient was successfully treated via ultrasound-guided percutaneous antegrade access of the testicular vein at the inguinal level with subsequent cyanoacrylate glue embolization as a minimally invasive alternative to surgical therapy. This is a new approach to varicocele embolization when the left renal vein does not feed the varicocele.
Highlights
IItt wwaass iimmppoossssiibbllee ttoo iiddeennttiiffyy the varicocele was supplied by the normal testicular vein
One explanation for the failure of the retrograde embolization was the competence of the first testicular vein valve at the level of the renal vein as often described despite the dilation of the testicular vein and the varicocele below
This valve could not be crossed. (B,C) Because of the inability to catheterize deeper the testicular vein with a microcatheter, cyanoacrylate glue embolization was directly performed through the 21-gauge needle
Summary
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