Lanza Ezio, Mininni Alessandra, Tomasino Luigi, Ammirabile Angela, Ferrillo Giuseppe, Romano Silvio, Poretti Dario, Francone Marco, Pedicini Vittorio
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
Department of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Int Urol Nephrol. 2025 Jun;57(6):1707-1714. doi: 10.1007/s11255-024-04347-4. Epub 2024 Dec 31.
This study investigated the long-term efficacy of n-butyl-2-cyanoacrylate-metacryloxysulpholane (NBCA-MS) for varicocele embolization (VE) without using a microcatheter.
A retrospective study was conducted on male patients who underwent VE with NBCA-MS for grade III-IV varicocele between January 2016 and December 2022. Patients were categorized by the catheter type used. Telephone interviews assessed long-term effectiveness, focusing on relapse, re-treatment and spermiogram improvements.
Of 185 patients, 102 completed the phone interview (median age 25 years, median follow-up 4.1 years). Sixty-six procedures were performed with only an HH1 catheter (Group A, 65%), and 36 required an additional microcatheter (Group B, 35%), with Group A having a shorter median procedure time (30 vs. 36.5 min, p = 0.004). Long-term follow-up indicated a low recurrence rate (12%) and spermiogram improvement among a subset of patients (81%), with no significant difference in long-term efficacy between groups (relapse p = 0.244, re-treatment p = 1). Costs increased by 47-56% when adding a microcatheter plus a 0.018-inch guidewire.
The study confirms the effectiveness and safety of VE with NBCA-MS, demonstrating low recurrence rates and improvements in groin discomfort and fertility outcomes. In most cases of varicocele embolization using NBCA-MS, microcatheters can be avoided, reducing procedural costs and duration without compromising long-term efficacy.
本研究探讨了在不使用微导管的情况下，正丁基-2-氰基丙烯酸酯-甲基丙烯酰氧基环丁砜（NBCA-MS）用于精索静脉曲张栓塞术（VE）的长期疗效。
对2016年1月至2022年12月期间接受NBCA-MS治疗III-IV级精索静脉曲张的男性患者进行回顾性研究。根据使用的导管类型对患者进行分类。通过电话访谈评估长期疗效，重点关注复发、再次治疗和精液检查结果的改善情况。
185例患者中，102例完成了电话访谈（中位年龄25岁，中位随访4.1年）。仅使用HH1导管进行了66例手术（A组，65%），36例需要额外使用微导管（B组，35%），A组的中位手术时间较短（30分钟对36.5分钟，p = 0.004）。长期随访显示复发率较低（12%），部分患者精液检查结果有所改善（81%），两组之间的长期疗效无显著差异（复发p = 0.244，再次治疗p = 1）。添加微导管和0.018英寸导丝后成本增加了47%-56%。
该研究证实了NBCA-MS用于VE的有效性和安全性，显示出低复发率以及腹股沟不适和生育结局的改善。在大多数使用NBCA-MS进行精索静脉曲张栓塞的病例中，可以避免使用微导管，在不影响长期疗效的情况下降低手术成本和缩短手术时间。
