CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2020; 4(02): 083-086
DOI: 10.4103/AJIR.AJIR_14_20
Original Article

Radiation Exposure during Varicocele Embolization: Does Access Site and Treated Side Matter?

Abdulaziz Alqubaisi
Departmentof Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Ali S Alsaadi
Department ofMedical Imaging, Maternity and Children Hospital, Ministry of Health, AlMedinah Almonawarah, Saudi Arabia,
,
Omar Bashir
Department of Medical Imaging, Division of Vascular and Interventional Radiology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Mohammad Arabi
Department of Medical Imaging, Division of Vascular and Interventional Radiology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
› Author Affiliations
Financial support and sponsorship Nil.

Purpose: The purpose of the study was to evaluate radiation exposure during varicocele embolization and correlate it with access site, embolized side, and complexity of varicoceles. Materials and Methods: This retrospective study included 39 adults who underwent varicocele embolization with a combination of coils and sclerosing agents between January 2015 and December 2018. Left-sided embolization was done in 26 patients and bilateral embolization in 13 patients. Jugular access was used in ten patients, whereas upper limb access was done in 29 patients. Dose area product (DAP) and total fluoroscopy time were collected and correlated to the treated side, access site, and complexity of varicoceles. Results: The mean fluoroscopy time for left varicocele embolization was 26.76 min, which was not statistically different (P = 0.16) compared to bilateral embolization (33.2 min). There was no statistical difference (P = 0.37) between the mean DAP for left embolization of 106,239 mGy.cm2 compared to bilateral DAP of 107,153 mGy.cm2. There was no difference in the mean DAP or fluoroscopy time between jugular vein access (DAP = 87,569 mGy.cm2, time = 34 min) and upper limb venous access (DAP = 113,086.8534 mGy.cm2, time = 28 min) with P = 0.64 and P = 0.14, respectively. There was no statistically significant correlation between the left varicocele Bähren classification and the fluoroscopy time (P = 0.52) or DAP (P = 0.76). Conclusion: This study finds no significant difference in DAP or fluoroscopy time between jugular and upper limb venous access or between left and bilateral embolization.



Publication History

Received: 25 April 2020
Received: 21 May 2020

Accepted: 17 June 2020

Article published online:
26 March 2021

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  • References

  • 1 Bähren W, Biehl C, Danz B. Failed sclerotherapy trials with the V. spermatica interna. A retrospective analysis in 1141 patients with idiopathic varicocele. Rofo 1992;157:355-60.
  • 2 Chalmers N, Hufton AP, Jackson RW, Conway B. Radiation risk estimation in varicocele embolization. Br J Radiol 2000;73:293-7.
  • 3 Flacke S, Schuster M, Kovacs A, von Falkenhausen M, Strunk HM, Haidl G, et al. Embolization of varicoceles: Pretreatment sperm motility predicts later pregnancy in partners of infertile men. Radiology 2008;248:540-9.
  • 4 Miller DL, Balter S, Cole PE, Lu HT, Schueler BA, Geisinger M, et al. Radiation doses in interventional radiology procedures: The RAD-IR study: Part I: Overall measures of dose. J Vasc Interv Radiol 2003;14:711-27.
  • 5 Verstandig AG, Shamieh B, Shraibman V, Raveh D. Radiation dose reduction in fluoroscopic procedures: Left varicocele embolization as a model. Eur Radiol 2015;25:1639-45.
  • 6 Pieri S, Agresti P, Morucci M, De Medici L, Fiocca G, Calisti A, et al. Analysis of radiation doses in the percutaneous treatment of varicocele in adolescents. Radiol Med 2003;105:500-10.
  • 7 Gioppo FM, Azzeroni R, Primolevo A, Cionfoli N, Spinazzola A, Cornalba G. Analysis of radiation dose in varicocele embolization using a last generation C-arm: Which risk for hereditary line? EPOS 2014. Pii: CR 2014/C-2178.
  • 8 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;111:449-58.
  • 9 Favard N, Moulin M, Fauque P, Bertaut A, Favelier S, Estivalet L, et al. Comparison of three different embolic materials for varicocele embolization: Retrospective study of tolerance, radiation and recurrence rate. Quant Imaging Med Surg 2015;5:806-14.