David N. McKinney BS, Presenter: Nothing to Disclose

John Miras Racadio MD, Abstract Co-Author: Research collaboration, Koninklijke Philips Electronics NV Speaker, Koninklijke Philips Electronics NV Medical Advisory Board, Koninklijke Philips Electronics NV

Manish Natvarlal Patel DO, Abstract Co-Author: Nothing to Disclose

Neil David Johnson MD, Abstract Co-Author: Nothing to Disclose

Doan N. Vu MD, Abstract Co-Author: Nothing to Disclose

Transcatheter injection of boiling hot contrast into the gonadal vein has been used successfully for retrograde varicocele embolization in adults for many years; however, this technique has not been described in a series of adolescents. While other methods of transcatheter embolization have become popular recently in adults (including coil embolization and injecting sclerosing agents such as alcohol, doxycycline, and sodium tetradecyl sulfate), we felt that the well-established method of injecting hot contrast would be just as effective as these newer transcatheter techniques. We also felt that injection of gelfoam plegets would help promote immediate thrombosis. We retrospectively reviewed cases in which hot contrast and gelfoam were used for adolescent varicocele embolization.

A retrospective chart review was conducted on all patients in whom varicocele embolization was performed using transcatheter injection of hot contrast and gelfoam plegets.

9 patients were identified (all left sided varicoceles); 5 of the 9 had recurrent varicoceles after failed surgical varicocelectomy. Mean age was 16.3 years (range: 12.8-18.9 years). All embolizations were immediately technically successful, demonstrating venous occlusion of the left gonadal vein as well as any parallel collateral veins draining the varicocele. 7 of the 9 have returned for clinical follow-up after a mean follow-up period of 30 weeks. All 7 had a clinically evident decrease in varicocele size without any reported complications. 2 of the 9 underwent embolization recently and have not yet had clinical follow-up. Due to clinical improvement, no patients have had follow-up imaging to date.

Retrograde embolization with hot contrast and gelfoam is a precise, immediate, safe, and low-cost way to treat adolescent varicoceles.

Adolescent varicoceles can be treated safely, effectively, and at low-cost with trans-catheter embolization using boiling contrast and gelfoam.

McKinney, D, Racadio, J, Patel, M, Johnson, N, Vu, D, Varicocele Embolization in Adolescents Using Boiling Contrast and Gelfoam.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6014667.html