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CIRSE Standards of Practice on Varicocele Embolisation

  • CIRSE Standards of Practice Guidelines
  • Venous Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Background

Percutaneous embolisation is an effective, minimally invasive means of treating a variety of benign and malignant lesions and has been successfully used to treat varicoceles since the late 1970s, with refined and expanded techniques and tools currently offering excellent outcomes for varicocele embolisation.

Purpose

This document will presume that the indication for treatment is clear and approved by the multidisciplinary team (MDT) and will define the standards required for the performance of each modality, as well as their advantages and limitations. CIRSE Standards of Practice documents are not intended to impose a standard of clinical patient care, but recommend a reasonable approach to, and best practices for, the performance of percutaneous varicocele embolisation.

Methods

The writing group was established by the CIRSE Standards of Practice Committee and consisted of five clinicians with internationally recognised expertise in embolisation of male varicoceles. The writing group reviewed the existing literature on varicocele embolisation, performing a pragmatic evidence search using PubMed to search for publications in English and relating to human subjects published from 2006 to 2021. The final recommendations were formulated through consensus.

Conclusion

Embolisation has an established role in the successful management of male varicoceles. This Standards of Practice document provides up-to-date recommendations for the safe performance of varicocele embolisation.

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Abbreviations

SOP:

Standards of Practice

ROS:

Reactive oxygen species

US:

Ultrasound

CDU:

Colour Doppler ultrasound

ESPU:

European Society for Paediatric Urology

FSH:

Follicle-stimulating hormone

LH:

Luteinising hormone

LHRH:

Luteinising hormone-releasing hormone

MDT:

Multidisciplinary team

DSA:

Digital subtraction angiography

STS:

Sodium tetradecyl sulphate

ISV:

Internal spermatic vein

OB:

Occluding balloon

RCT:

Randomised controlled trial

KAP:

Kerma area product

Gycm2 :

Gray centimetres-squared

mSv:

Millisievert

TS:

Technical success

CS:

Clinical success

mL:

Milliliters

References

  1. Macey MR, Owen RC, Ross SS, Coward RM. Best practice in the diagnosis and treatment of varicocele in children and adolescents. Ther Adv Urol. 2018;10(9):273–82.

    Article  Google Scholar 

  2. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, Rienzi L, Sunde A, Schmidt L, Cooke ID, Simpson JL, van der Poel S. The international glossary on infertility and fertility care. Fertil Steril. 2017;108(3):393–406.

    Article  Google Scholar 

  3. Shridharani A, Owen RC, Elkelany OO, Kim ED. The significance of clinical practice guidelines on adult varicocele detection and management. Asian J Androl. 2016;18(2):269–75. https://doi.org/10.4103/1008-682X.172641.

    Article  Google Scholar 

  4. Persad E, O’Loughlin CA, Kaur S, Wagner G, Matyas N, HasslerDi Fratta MR, NussbaumerStreit B. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021;2021(4):CD000479.

    Google Scholar 

  5. Abdel-Meguid TA, Al-Sayyad A, Tayib A, Farsi HM. Does varicocele repair improve male infertility? an evidence-based perspective from a randomized, controlled trial. Eur Urol. 2011;59(3):455–61.

    Article  Google Scholar 

  6. Roque M, Esteves SC. A systematic review of clinical practice guidelines and best practice statements for the diagnosis and management of varicocele in children and adolescents. Asian J Androl. 2016;18(2):262–8.

    Article  Google Scholar 

  7. Dubin L, Amelar RD. Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertil Steril. 1970;21(8):606–9.

    Article  CAS  Google Scholar 

  8. Esteves SC, Miyaoka R, Roque M, Agarwal A. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian J Androl. 2016;18(2):246–53.

    Article  Google Scholar 

  9. Mancini M, Carrafiello G, Melchiorre F, Pelliccione F, Andreassi A, Mantellassi G, AhmedSaid Z, Pecori Giraldi F, Banderali G, Folli F. Early varicocelectomy by percutaneous scleroembolization improves seminiferous tubules spermatozoa release in the adolescent phase of testicular growth. Andrologia. 2019;51(7):e13286.

    Article  Google Scholar 

  10. Cantoro U, Polito M, Muzzonigro G. Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study. Urology. 2015;85(4):826–30.

    Article  Google Scholar 

  11. Sack BS, Schäfer M, Kurtz MP. The dilemma of adolescent aricoceles: Do they really have to be repaired? Curr Urol Rep. 2017;18(5):38.

    Article  Google Scholar 

  12. Wong S, Vigneswaran G, Maclean D, Bryant T, Hacking N, Maher B, Somani B, Manoharan S, Brownlee E, Griffin S, Modi S. 10-year experience of Paediatric varicocele embolization in a tertiary centre with long-term follow-up. J Pediatr Urol. 2022;18(2):113.e1-113.e6.

    Article  Google Scholar 

  13. Stahl P, Schlegel PN. Standardization and documentation of varicocele evaluation. Curr Opin Urol. 2011;21(6):500–5.

    Article  Google Scholar 

  14. Sarteschi LM. Lo studio del varicocele con eco-color-doppler. G Ital Di Ultrason. 1993;4(2):43–9.

    Google Scholar 

  15. Freeman S, Bertolotto M, Richenberg J, Belfield J, Dogra V, Huang DY, Lotti F, Markiet K, Nikolic O, Ramanathan S, Ramchandani P, Rocher L, Secil M, Sidhu PS, Skrobisz K, Studniarek M, Tsili A, Tuncay Turgut A, Pavlica P, Derchi LE. members of the ESUR-SPIWG WG. Ultrasound evaluation of varicoceles: guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection, classification, and grading. Eur Radiol. 2020;30:11–25.

    Article  Google Scholar 

  16. Foroughi AA, Yazdanpanah E, Nazeri M, Eghbali T, Arasteh P, Ariafar A. Clinical grading and color doppler ultrasonography-based grading of varicocele: how compatible are the two grading systems? World J Urol. 2019;37(7):1461–5.

    Article  Google Scholar 

  17. Tekgul S, Dogan H, Erdem E, Hoebeke P, Kocvara R. Guidelines on paediatric urology 2015: European association of urology and european society of paediatric urology. 2015. http://www.uroweb.org/Guideline/Paediatric-urology.

  18. Jungwirth A, Diemer T, Dohle G, Giwercman A, Kopa Z. EAU Guidelines of male infertility, Edn. Presented at the EAU annual congress amsterdam, the netherlands. 2013. http://www.uroweb.org/guideline/male-infertility/.

  19. Salonia A, Bettocchi C, Carvalho J, Corona G, Jones TH, Kadioğlu A, Martinez-Salamanca JI, Minhas S, Serefoğlu EC, Verze P, et al. EAU Guidelines on sexual and reproductive health, Edn. presented at the EAU annual congress Amsterdam, the Netherlands. 2022. https://uroweb.org/guidelines/sexual-and-reproductive-health.

  20. Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HWG, Behre HM, Haugen TB, Kruger T, Wang C, Mbizvo MT, Vogelsong KM. World health organization reference values for human semen characteristics. Hum Reprod Update. 2010;16(3):231–45.

    Article  Google Scholar 

  21. Aragona F, Ragazzi R, Pozzan GB, de Caro R, Munari PF, Milani C, Glazel GP. Correlation of testicular volume, histology and LHRH test in adolescents with idiopathic varicocele. Eur Urol. 1994;26(1):61–6.

    Article  CAS  Google Scholar 

  22. Sharlip ID, Jarow JP, Belker AM, Lipshultz LI, Sigman M, Thomas AJ, Schlegel PN, Howards SS, Nehra A, Damewood MD, Overstreet JW, Sadovsky R. Best practice policies for male infertility. Fertil Steril. 2002;77(5):873–82.

    Article  Google Scholar 

  23. Johnson D, Sandlow J. Treatment of varicoceles: techniques and outcomes. Fertil Steril. 2017;108(3):378–84.

    Article  Google Scholar 

  24. Raheem O. Surgical management of adolescent varicocele: Systematic review of the world literature. Urol Ann. 2013;5(3):133–9.

    Article  Google Scholar 

  25. Castagnetti M, Cimador M, Catalano P, DiPace M, Sergio M, de Grazia E. Evolving management of adolescent varicocele. J Pediatr Urol. 2008;4(2):107–12.

    Article  Google Scholar 

  26. Sepúlveda L, Coimbra D, Lourenço M, Santos L, Oliveira C, Coutinho S, Ramos M. Varicocele treatment in patients up to 35 years old: a multicentric retrospective study comparing 3 different techniques. Arch Esp Urol. 2018;71(6):543–8.

    Google Scholar 

  27. Glassberg KI, Poon SA, Gjertson CK, DeCastro GJ, Misseri R. Laparoscopic lymphatic sparing varicocelectomy in adolescents. J Urol. 2008;180(1):326–31.

    Article  Google Scholar 

  28. Barroso U, Andrade DM, Novaes H, Netto JMB, Andrade J. Surgical treatment of varicocele in children with open and laparoscopic Palomo technique: a systematic review of the literature. J Urol. 2009;181(6):2724–8.

    Article  Google Scholar 

  29. Jing YX, Wang RH, Liu ZX, Meng QY. Analysis of internal spermatic vein embolization through catheter versus laparoscopic high ligation in treatment of left varicocele. Vascular. 2020;28(5):583–90.

    Article  CAS  Google Scholar 

  30. Liu Q, Zhang X, Zhou F, Xi X, Lian S, Lian Q. Comparing Endovascular and Surgical Treatments for Varicocele: A Systematic Review and Meta-Analysis. J Vasc Interv Radiol. 2022;33(7):834–40.

    Article  Google Scholar 

  31. Galfano A, Novara G, Iafrate M, Fracalanza S, Novella G, Cavalleri S, Artibani W, Ficarra V. Surgical outcomes after modified antegrade scrotal sclerotherapy: a prospective analysis of 700 consecutive patients with idiopathic varicocele. J Urol. 2008;179(5):1933–7.

    Article  Google Scholar 

  32. Verstandig AG, Shamieh B, Shraibman V, Raveh D. Radiation dose reduction in fluoroscopic procedures: left varicocele embolization as a model. Eur Radiol. 2015;25(6):1639–45.

    Article  Google Scholar 

  33. Hadi M, Walker C, Desborough M, Basile A, Tsetis D, Hunt B, Müller-Hüllsbeck S, Rand T, van Delden O, Uberoi R. CIRSE standards of practice on peri-operative anticoagulation management during interventional radiology procedures. Cardiovasc Interv Radiol. 2021;44(4):523–36.

    Article  Google Scholar 

  34. Iaccarino V, Venetucci P. Interventional radiology of male varicocele: current status. Cardiovasc Interv Radiol. 2012;35(6):1263–80.

    Article  Google Scholar 

  35. Kuroiwa T, Hasuo K, Yasumori K, Mizushima A, Yoshida K, Hirakata R, Komatsu K, Yamaguchi A, Masuda K. Transcatheter embolization of testicular vein for varicocele testis. Acta Radiol. 1991;32(4):311–4.

    Article  CAS  Google Scholar 

  36. Wadhwa V, Kashanian JA, Schiffman M, McClure TD. Varicocele embolization: patient selection: preprocedure workup, and technical considerations. Semin Interv Radiol. 2021;38(2):176–81.

    Article  Google Scholar 

  37. Gazzera C, Rampado O, Savio L, di Bisceglie C, Manieri C, Gandini G. Radiological treatment of male varicocele: technical, clinical, seminal and dosimetric aspects. Radiol Med. 2006;111(3):449–58.

    Article  CAS  Google Scholar 

  38. Vanlangenhove P, de Keukeleire K, Everaert K, van Maele G, Defreyne L. Efficacy and safety of two different n-butyl-2-cyanoacrylates for the embolization of varicoceles: a prospective, randomized, blinded study. Cardiovasc Interv Radiol. 2012;35(3):598–606.

    Article  Google Scholar 

  39. Perdikakis E, Fezoulidis I, Tzortzis V, Rountas C. Varicocele embolization: Anatomical variations of the left internal spermatic vein and endovascular treatment with different types of coils. Diagn Interv Imaging. 2018;99(10):599–607.

    Article  CAS  Google Scholar 

  40. Bähren W, Biehl C, Danz B. Failed sclerotherapy trials with the V. spermatica interna. A retrospective analysis in 1141 patients with idiopathic varicocele. RoFo Fortschr Auf Dem Geb Der Rontgenstrahl Und Der Nukl. 1992;157(4):355–60.

    Google Scholar 

  41. Siegel Y, Gat Y, Bacher GN, Gornish M. A proposed anatomic typing of the right internal spermatic vein: importance for percutaneous sclerotherapy of varicocele. Cardiovasc Interv Radiol. 2006;29(2):192–7.

    Article  Google Scholar 

  42. Makris GC, Efthymiou E, Little M, Boardman P, Anthony S, Uberoi R, Tapping C. Safety and effectiveness of the different types of embolic materials for the treatment of testicular varicoceles: a systematic review. Br J Radiol. 2018;91(1088):20170445.

    Article  Google Scholar 

  43. Ali A, Wirth S, Treitl KM, Treitl M. Treatment of male varicoceles by transcatheter polidocanol foam sclerotherapy: evaluation of clinical success, complications, and patients’ satisfaction with regard to alternative techniques. Eur Radiol. 2015;25(10):2889–97.

    Article  Google Scholar 

  44. Gandini R, Konda D, Reale CA, Pampana E, Maresca L, Spinelli A, Stefanini M, Simonetti G. Male varicocele: transcatheter foam sclerotherapy with sodium tetradecyl sulfate–outcome in 244 patients. Radiology. 2008;246(2):612–8.

    Article  Google Scholar 

  45. Favard N, Moulin M, Fauque P, Bertaut A, Favelier S, Estivalet L, Michel F, Cormier L, Sagot P, Loffroy R. Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate. Quant Imaging Med Surg. 2015;5(6):806–14.

    Google Scholar 

  46. Tiralongo F, Distefano G, Palermo M, Granata A, Giurazza F, Vacirca F, Palmucci S, Venturini M, Basile A. Liquid and solid embolic agents in gonadal veins. J Clin Med. 2021;10(8):1596.

    Article  CAS  Google Scholar 

  47. Basile A, Failla G, la Vignera S, Condorelli RA, Calogero A, Vicari E, Granata A, Mundo E, Caltabiano G, Pizzarelli M, Messina M, Scavone G, Lanzafame F, Iezzi R, Tsetis D. Left spermatic vein retrograde sclerosis: comparison between sclerosant agent injection through a diagnostic catheter versus through an occluding balloon catheter. Radiol Med. 2015;120(5):483–8.

    Article  Google Scholar 

  48. Carmignani L, Casellato S, Galasso G, Bozzini G, Spinelli M, Dell’Agnola CA, Rocco F. Sclerotherapy of the pampiniform plexus with modified Marmar technique in children and adolescents. Urol Int. 2009;82(2):187–90.

    Article  Google Scholar 

  49. Cil B, Peynircioğlu B, Canyiğit M, Geyik S, Ciftçi T. Peripheral vascular applications of the Amplatzer vascular plug. Diagn Interv Radiol. 2008;14(1):35–9.

    Google Scholar 

  50. Guevara CJ, El-Hilal AH, Darcy MD. Percutaneous antegrade varicocele embolization via the testicular vein in a patient with recurrent varicocele after surgical repair. Cardiovasc Interv Radiol. 2015;38(5):1325–9.

    Article  Google Scholar 

  51. Kunnen M. New techniques for embolisation of the internal spermatic vein intravenous tissue adhesive author’s transl. RoFo Fortschr Auf Dem Geb Der Rontgenstrahl Und Der Nukl. 1980;133(6):625–9.

    Article  CAS  Google Scholar 

  52. Bilreiro C, Donato P, Costa JF, Agostinho A, Carvalheiro V, Caseiro-Alves F. Varicocele embolization with glue and coils: a single center experience. Diagn Interv Imaging. 2017;98(7–8):529–34.

    Article  CAS  Google Scholar 

  53. Sze DY, Kao JS, Frisoli JK, McCallum SW, Kennedy WA, Razavi MK. Persistent and recurrent postsurgical varicoceles: venographic anatomy and treatment with N-butyl cyanoacrylate embolization. J Vasc Interv Radiol. 2008;19(4):539–45.

    Article  Google Scholar 

  54. Chevallier O, Fauque P, Poncelet C, Guillen K, Comby PO, Astruc K, Barberet J, Falvo N, Simon E, Loffroy R. Relevant biological effects of varicocele embolization with N-Butyl cyanoacrylate glue on semen parameters in infertile men. Biomedicines. 2021;9(10):1423.

    Article  CAS  Google Scholar 

  55. Chevallier O, Pellegrinelli J, Guillen K, Loffroy R. Ultrasound-guided percutaneous antegrade varicocele embolization with cyanoacrylate glue as an alternative to the standard retrograde approach. Diagnostics. 2020;10(6):432.

    Article  Google Scholar 

  56. Boeri L, Fulgheri I, Cristina M, Biondetti P, Rossi S, Grimaldi E, Lucignani G, Gadda F, Ierardi AM, Salonia A, Viganò P, Somigliana E, Carrafiello G, Montanari E. Varicocoele embolization with sclerosing agents leads to lower radiation exposure and procedural costs than coils: Data from a real-life before and after study. Andrology. 2022;10(4):694–701.

    Article  CAS  Google Scholar 

  57. Roy JR, Sun P, Ison G, Prasan AM, Ford T, Hopkins A, Ramsay DR, Weaver JC. Selective anti-scatter grid removal during coronary angiography and PCI: a simple and safe technique for radiation reduction. Int J Cardiovasc Imaging. 2017;33(6):771–8.

    Article  Google Scholar 

  58. Fritz S, Jones AK. Guidelines for anti-scatter grid use in pediatric digital radiography. Pediatr Radiol. 2014;44(3):313–21.

    Article  Google Scholar 

  59. Tsapaki V. Radiation dose optimization in diagnostic and interventional radiology: Current issues and future perspectives. Phys Med. 2020;79:16–21.

    Article  Google Scholar 

  60. Chalmers N, Hufton AP, Jackson RW, Conway B. Radiation risk estimation in varicocele embolization. Br J Radiol. 2000;73(867):293–7.

    Article  CAS  Google Scholar 

  61. Alqubaisi A, Alsaadi AS, Bashir O, Arabi M. Radiation exposure during varicocele embolization: does access site and treated side matter? The Arab Journal of Interventional Radiology. 2020;4(2):083–6.

    Article  Google Scholar 

  62. Malekzadeh S, Fraga-Silva RA, Morère PH, Sorega A, Produit S, Stergiopulos N, Constantin C. Varicocele percutaneous embolization outcomes in a pediatric group: 7-year retrospective study. Int Urol Nephrol. 2016;48(9):1395–9.

    Article  CAS  Google Scholar 

  63. Chung E. Postvaricocele embolization pain syndrome: a case series report and review of current treatment strategies. J Endovasc Ther. 2022;152660282210864

  64. Halpern J, Mittal S, Pereira K, Bhatia S, Ramasamy R. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications. Asian J Androl. 2016;18(2):234–8.

    Article  Google Scholar 

  65. Cassidy D, Jarvi K, Grober E, Lo K. Varicocele surgery or embolization: Which is better? Can Urol Assoc J. 2012;6(4):266–8.

    Article  Google Scholar 

  66. Kim J, Shin JH, Yoon HK, Ko GY, Gwon DI, Kim EY, Sung KB. Persistent or recurrent varicocoele after failed varicocoelectomy: outcome in patients treated using percutaneous transcatheter embolization. Clin Radiol. 2012;67(4):359–65.

    Article  CAS  Google Scholar 

  67. Jargiello T, Drelich-Zbroja A, Falkowski A, Sojka M, Pyra K, Szczerbo-Trojanowska M. Endovascular transcatheter embolization of recurrent postsurgical varicocele: anatomic reasons for surgical failure. Acta Radiol. 2015;56(1):63–9.

    Article  Google Scholar 

  68. Kroese ACJ, de Lange NM, Collins J, Evers JLH. Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst Rev. 2012;10:CD000479.

    Google Scholar 

  69. Sansone A, Fegatelli DA, Pozza C, Fattorini G, Lauretta R, Minnetti M, Romanelli F, Lucatelli P, Corona M, Bezzi M, Lombardo F, Lenzi A, Gianfrilli D. Effects of percutaneous varicocele repair on testicular volume: results from a 12-month follow-up. Asian J Androl. 2019;21(4):408–12.

    Article  CAS  Google Scholar 

  70. Lotti F, Frizza F, Balercia G, Barbonetti A, Behre HM, Calogero AE, Cremers JF, Francavilla F, Isidori AM, Kliesch S, la Vignera S, Lenzi A, Marcou M, Pilatz A, Poolamets O, Punab M, Peraza Godoy MF, Rajmil O, Salvio G, Shaeer O, Weidner W, Maseroli E, Cipriani S, Baldi E, Degl’Innocenti S, Danza G, Caldini AL, Terreni A, Boni L, Krausz C, Maggi M. The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Scrotal ultrasound reference ranges and associations with clinical, seminal, and biochemical characteristics. Andrology. 2021;9(2):559–76.

    Article  CAS  Google Scholar 

  71. Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Interv Radiol. 2017;40(8):1141–6.

    Article  CAS  Google Scholar 

  72. Miller DL, Balter S, Dixon RG, Nikolic B, Bartal G, Cardella JF, Dauer LT, Stecker MS. Society of interventional radiology standards of practice committee quality improvement guidelines for recording patient radiation dose in the medical record for fluoroscopically guided procedures. J Vasc Interv Radiol. 2012;23(1):11–8.

    Article  Google Scholar 

  73. Bonkat G, Bartoletti R, Bruyère F, Cai T, Geerlings SE, Köves B, Schubert S, Pilatz A, Veeratterapillay R, Wagenlehner F, et al. EAU guidelines on urological infections, Edn. Presented at the EAU annual congress Amsterdam, the Netherlands. 2022; https://uroweb.org/guidelines/urological-infections.

  74. Lurvey R, Durbin-Johnson B, Kurzrock EA. Adolescent varicocele: A large multicenter analysis of complications and recurrence in academic programs. J Pediatr Urol. 2015;11(4):186.e1-6.

    Article  Google Scholar 

  75. Broe MP, Ryan JPC, Ryan EJ, Murphy DJ, Mulvin DW, Cantwell C, Brophy DP. Spermatic vein embolization as a treatment for symptomatic varicocele. Can Urol Assoc J. 2021;15(11):E569–73.

    Article  Google Scholar 

  76. Li L, Zeng XQ, Li YH. Safety and effectiveness of transcatheter foam sclerotherapy for testicular varicocele with a fluoroscopic tracing technique. J Vasc Intervent Radiol. 2010;21(6):824–8.

    Article  Google Scholar 

  77. Motta A, Caltabiano G, Pizzarelli M, Failla G, Botezatu D, Muresanu H, Foti P, la Vignera S, Condorelli R, Palmucci S, Basile A. Varicocele, conventional laparoscopic ligation versus occluding balloon embolization. Radiol Med. 2019;124(5):438–43.

    Article  Google Scholar 

  78. Riede P, McCarthy E, Cary R, Boardman P, Tapping CR. Neck or groin access for varicocele embolisation: Is it important? J Med Imaging Radiat Oncol. 2016;60(6):728–32.

    Article  Google Scholar 

  79. Puche-Sanz I, Flores-Martín JF, Vázquez-Alonso F, Pardo-Moreno PL, Cózar-Olmo JM. Primary treatment of painful varicocoele through percutaneous retrograde embolization with fibred coils. Andrology. 2014;2(5):716–20.

    Article  CAS  Google Scholar 

  80. Cayan S, Shavakhabov S, Kadioğlu A. Treatment of palpable varicocele in infertile men: a meta-analysis to define the best technique. J Androl. 2009;30(1):33–40.

    Article  Google Scholar 

  81. Sousa AP, Santos-Pereira J, Freire MJ, Parada B, Almeida-Santos T, Bernardino J, Ramalho-Santos J. Using data mining to assist in predicting reproductive outcomes following varicocele embolization. J Clin Med. 2021;10(16):3503.

    Article  Google Scholar 

  82. Nabi G, Asterlings S, Greene DR, Marsh RL. Percutaneous embolization of varicoceles: outcomes and correlation of semen improvement with pregnancy. Urology. 2004;63(2):359–63.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    Anna Maria Ierardi & Pierpaolo Biondetti

  2. Department of Medical Imaging, University Hospital Heraklion, University of Crete Medical School, Heraklion, Greece

    Dimitrios Tsetis

  3. Department of Radiology, Institut Mutualiste Montsouris, Paris, France

    Costantino Del Giudice

  4. Department of Vascular and Interventional Radiology, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK

    Raman Uberoi

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  1. Anna Maria Ierardi
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  5. Raman Uberoi
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Appendix

Appendix

See Table 5, 6 and 7

Table 5 Technical success
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Table 6 Clinical success
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Table 7 Complications
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Ierardi, A.M., Biondetti, P., Tsetis, D. et al. CIRSE Standards of Practice on Varicocele Embolisation. Cardiovasc Intervent Radiol 46, 19–34 (2023). https://doi.org/10.1007/s00270-022-03293-x

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