Roberto Gandini MD, Abstract Co-Author: Nothing to Disclose

Daniel Konda, Presenter: Nothing to Disclose

Marcello Chiocchi MD, Abstract Co-Author: Nothing to Disclose

Eleonora Gaspari, Abstract Co-Author: Nothing to Disclose

Luca Boi MD, Abstract Co-Author: Nothing to Disclose

Giovanni Simonetti MD, Abstract Co-Author: Nothing to Disclose

To assess the efficacy of Balloon-Occluded Retrograde Transvenous Foam Sclerotherapy (B-ORTFS) in high-flow pelvic varicocele using 3% sodium-tetradecyl-sulphate (STS) foam.

A retrospective study was conducted in 12 patients (mean age: 35.2 years; range: 23-46) with pelvic congestion syndrome (PCS) with atypical high-flow venous collaterals treated by B-ORTFS between June 2005 and May 2008 at our Department. Full approval and waiver of informed consent for our study was obtained by our institutional review board. PCS was diagnosed by physical and transvaginal color-Doppler US examination, while high-flow venous collaterals were detected at selective ovarian venography. B-ORTFD was performed by injection of 3% STS foam into the pelvic varices after balloon-occlusion of the major venous vessels (hypogastric or ovarian veins) to which the high-flow venous collaterals were tributary. Follow-up was performed at 1, 3, 6 and 12 months by physical and transvaginal color-Doppler US examination and by a questionnaire-based assessment of pain using a Symptom Severity Score (SSS).

The procedure was technical successful in all patients (100%). After the injection of 3% STS foam, 3 (25.0%) patients presented a colic-like pain with spontaneous resolution after 5 minutes. During follow-up, no recurrences of PCS were detected. A significant improvement of symptoms (Student’s t test P<0.01) was observed at 1, 3, 6 and 12 months.

B-ORTFS of high-flow female varicocele using 3% STS foam is a safe and effective procedure that should be taken into consideration as an alternative to other endovascular and surgical options.

Treatment of PCS with high-flow venous collaterals by B-ORTFS is a safe and effective alternative to conventional surgical techniques that is associated to lower complication rates.

Gandini, R, Konda, D, Chiocchi, M, Gaspari, E, Boi, L, Simonetti, G, Treatment of Symptomatic High-Flow Female Varicocele with Balloon-occluded Retrograde Transvenous Foam Sclerotherapy (B-ORTFS) Using Sodium-tetradecyl-sulphate Foam.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008939.html