Percutaneous Anterograde Varicocele Embolisation: Technique and Clinical Outcomes.

Transcatheter retrograde testicular vein embolisation for symptomatic varicoceles is well-established but has a documented failure rate. Percutaneous anterograde varicocele embolisation may be a suitable alternative. A retrospective observational, descriptive study of consecutive patients who underwent percutaneous anterograde varicocele embolisation at a single centre was performed. Twenty patients (16 adults, 4 adolescents) underwent unilateral varicocele treatment. Technical success rate was 100%. Mean (SD) fluoroscopy time was 106.5 (24.9) seconds. For patients treated for subfertility, mean (SD) DNA fragmentation index significantly decreased from 29.4 (4.48)% to 22 (2.45)% pre and post procedure. No clinical or radiological evidence of varicocele recurrence was detected at 1- and 2- year follow-up. Four patients (20%) experienced self-limiting pain. No major adverse events occurred. Percutaneous anterograde varicocele embolisation appears to be safe with high technical and clinical success rate. Larger studies are required to further evaluate this. Radiation dose may be lower than with retrograde embolisation.