Reyes B L, Trerotola S O, Venbrux A C, Savader S J, Lund G B, Peppas D S, Mitchell S E, Gearhart J P, White R I, Osterman F A
Cardiovascular Diagnostic Laboratory, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Md.
J Vasc Interv Radiol. 1994 Jan-Feb;5(1):131-4. doi: 10.1016/s1051-0443(94)71469-x.
The authors evaluated the technical success and immediate and long-term results of percutaneous varicocele embolotherapy in the adolescent population.
Fifty-nine adolescent patients were referred for outpatient spermatic venography and possible varicocele embolotherapy. Embolization was attempted with use of detachable balloons, coils, "sandwiched" dextrose, or a combination of these techniques. Data regarding follow-up were obtained through telephone interviews or mailed questionnaires.
The technical success rate for spermatic vein occlusion was 90%. Follow-up, obtained in 79% of the patients, ranged from 6 months to 8.75 years (mean, 4 years). Thirty-nine of 42 patients (93%) reported disappearance (n = 31) or only a slight, asymptomatic residual varicocele (n = 8). Three patients reported a recurrence of their varicocele. Complications occurred in three of 59 cases (5%), none had any long-term sequelae. In six cases, embolization was not feasible because of multiple collateral vessels or venous spasm.
Given the convenience of performing the procedure on an outpatient basis, the rapid recovery time, and long-term success and complication rates comparable to those with surgical ligation, we believe spermatic venography and percutaneous embolization is the treatment modality of choice for adolescent varicocele.
作者评估了青少年人群经皮精索静脉曲张栓塞治疗的技术成功率以及近期和远期疗效。
59例青少年患者被转诊接受门诊精索静脉造影及可能的精索静脉曲张栓塞治疗。尝试使用可脱性球囊、弹簧圈、“夹心”葡萄糖或这些技术的联合进行栓塞。通过电话访谈或邮寄问卷获取随访数据。
精索静脉闭塞的技术成功率为90%。79%的患者获得随访，时间从6个月至8.75年（平均4年）。42例患者中的39例（93%）报告精索静脉曲张消失（31例）或仅残留轻微无症状的精索静脉曲张（8例）。3例患者报告精索静脉曲张复发。59例中有3例（5%）发生并发症，均无长期后遗症。6例因多条侧支血管或静脉痉挛而无法进行栓塞。
鉴于该手术可在门诊进行，恢复快，且长期成功率和并发症发生率与手术结扎相当，我们认为精索静脉造影和经皮栓塞是青少年精索静脉曲张的首选治疗方式。
