Tiralongo Francesco, Distefano Giulio, Palermo Monica, Granata Antonio, Giurazza Francesco, Vacirca Francesco, Palmucci Stefano, Venturini Massimo, Basile Antonio
Radiology Unit I, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia"-University Hospital "Policlinico-San Marco", University of Catania, Via Santa Sofia n° 78, 95123 Catania, Italy.
Nephrology and Dialysis Unit, "Cannizzaro" Hospital, 95123 Catania, Italy.
J Clin Med. 2021 Apr 9;10(8):1596. doi: 10.3390/jcm10081596.
Male varicocele and pelvic congestion syndrome (PCS) are common pathologies with high predominance in young patients, having a high impact on the quality of life and infertility. Lately, the use of different endovascular embolization techniques, with various embolizing agents, shows good technical results and clinical outcomes. With the aim of presenting the "state of the art" of endovascular techniques for the treatment of male varicocele and PCS, and to discuss the performance of the different embolic agents proposed, we conducted an extensive analysis of the relevant literature and we reported and discussed the results of original studies and previous meta-analyses, providing an updated guide on this topic to clinicians and interventional radiologists. We have also underlined the technical aspects for the benefit of those who approach this type of interventional treatment. Our review suggests promising results in both the endovascular embolic treatment of male varicocele and PCS; for varicocele, a success rate of between 70% and 100% and a recurrence rate of up to 16% is reported, while for PCS it has been found that technical success is achieved in almost all cases of endovascular treatment, with a highly variable recurrence rate based on reports. Complications are overall rather rare and are represented by periprocedural pain, migration of embolic media and vascular perforations: severe adverse events have been reported very rarely.
男性精索静脉曲张和盆腔充血综合征（PCS）是常见病症，在年轻患者中高发，对生活质量和不育症有很大影响。最近，使用不同的血管内栓塞技术及各种栓塞剂，显示出良好的技术效果和临床结果。为了介绍治疗男性精索静脉曲张和PCS的血管内技术的“最新进展”，并讨论所提出的不同栓塞剂的性能，我们对相关文献进行了广泛分析，并报告和讨论了原始研究及先前荟萃分析的结果，为临床医生和介入放射科医生提供了关于该主题的最新指南。我们还强调了技术方面，以造福那些进行此类介入治疗的人员。我们的综述表明，男性精索静脉曲张和PCS的血管内栓塞治疗均有令人期待的结果；对于精索静脉曲张，报告的成功率在70%至100%之间，复发率高达16%，而对于PCS，已发现几乎所有血管内治疗病例均取得技术成功，根据报告复发率差异很大。总体而言，并发症相当罕见，表现为围手术期疼痛、栓塞介质移位和血管穿孔：极少报告有严重不良事件。
