Selecting patients for embolization of varicoceles based on ultrasonography

• Authors: Łukasz Światłowski , Krzysztof Pyra , Maryla Kuczyńska , Ewa Kuklik , Jan Sobstyl , Michał Sojka , Anna Drelich-Zbroja , Maciej Pech , Maciej Powerski , Tomasz Jargiełło

Title variants

PL

Kwalifikacja ultrasonograficzna do zabiegu embolizacji żylaków powrózka nasiennego

• Languages of publication: EN PL

Abstracts

EN

Aim: The aim of the study was to assess patient selection for embolization of varicoceles based on ultrasonography. An additional objective of the work was to evaluate the results of endovascular treatment. Material and methods: From January 2015 till August 2017, 53 patients with varicoceles diagnosed in an ultrasound examination underwent endovascular treatment in the Department of Interventional Radiology and Neuroradiology in Lublin, Poland. Each ultrasound examination was performed using the Logiq 7 GE Medical System with a linear probe at 6–12 MHz using the B-mode and Doppler functions. The study was performed in both the supine and standing position of the patient. The morphological structures of the scrotum and the width of the pampiniform venous plexus were assessed. Based on clinical signs and symptoms as well as ultrasound findings, the patients were selected for endovascular treatment. This procedure involved the implantation of coils in the distal and proximal parts of the testicular vein and administration of a sclerosing agent between the coils. Results: Varicoceles were confirmed in all patients during a color Doppler scan. Diagnostic venography confirmed venous stasis or retrograde flow in the testicular vein and widened vessels of the pampiniform venous plexus over 2 mm in diameter in all patients undergoing endovascular treatment. The diagnostic efficacy of ultrasound was 100%. The technical success of the procedure was 89%. One patient had a recurrence of varicose veins (2.2%). There were no complications in any of the patients. Conclusions: Ultrasound is the preferred method in the diagnosis of varicoceles and selection for their treatment. Testicular vein embolization is a minimally invasive procedure characterized by high efficacy and safety.

PL

Cel: Celem pracy jest ocena ultrasonograficznej kwalifikacji do zabiegu embolizacji żylaków powrózka nasiennego, a także ocena wyników zabiegu wewnątrznaczyniowego.Materiał i metoda: W okresie od stycznia 2015 do sierpnia 2017 roku w Zakładzie Radiologii Zabiegowej i Neuroradiologii w Lublinie poddano leczeniu zabiegowemu 53 chorych, u których rozpoznano w badaniu ultrasonograficznym żylaki powrózka nasiennego. Każde badanie ultrasonograficzne wykonywano aparatem Logiq 7 GE Medical System przy użyciu sondy linearnej o częstotliwości 6–12 MHz z wykorzystaniem opcji B-mode oraz dopplerowskich. Badanie przeprowadzono zarówno w pozycji leżącej, jak i stojącej chorego. Oceniano morfologiczne struktury worka mosznowego i szerokość naczyń splotu wiciowatego. Na podstawie objawów klinicznych i wyniku badania ultrasonograficznego chorzy byli kwalifikowani do leczenia wewnątrznaczyniowego. Zabieg polegał na implantacji spiral w odcinku dystalnym i proksymalnym żyły jądrowej i podawaniu pomiędzy spirale substancji obliterującej naczynie.Wyniki: U wszystkich chorych w wykonanym badaniu ultrasonograficznym z opcją kolorowego dopplera potwierdzono występowanie żylaków powrózka nasiennego. U wszystkich chorych poddanych zabiegowi embolizacji podczas diagnostycznej flebografii potwierdzono występowanie zastoju żylnego lub refluksu wstecznego w żyle jądrowej oraz poszerzone naczynia żylne, powyżej 2 mm średnicy. Skuteczność rozpoznania żylaków powrózka nasiennego za pomocą badania ultrasonograficznego wyniosła 100%. Powodzenie techniczne procedury wyniosło 89%. U jednego chorego nastąpił nawrót żylaków (2,2%). U żadnego chorego nie wystąpiły jakiekolwiek powikłania. Wnioski: Badanie ultrasonograficzne jest metodą z wyboru w rozpoznawaniu żylaków powrózka nasiennego i kwalifikowaniu chorych do zabiegu. Embolizacja żyły jądrowej to zabieg charakteryzujący się wysoką skutecznością i bezpieczeństwem w leczeniu żylaków powrózka nasiennego.

Keywords

EN

diagnostic imaging; interventionalradiology; ultrasonography; varicocele

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Journal of Ultrasonography
• Year: 2018
• Volume: 18
• Issue: 73
• Pages: 90–95

Contributors

author

Łukasz Światłowski

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

author

Krzysztof Pyra

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

author

Maryla Kuczyńska

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

author

Ewa Kuklik

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

author

Jan Sobstyl

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

author

Michał Sojka

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

author

Anna Drelich-Zbroja

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

author

Maciej Pech

• Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Niemcy

author

Maciej Powerski

• Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Niemcy

author

Tomasz Jargiełło

• Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

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• Document Type: article