Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate

Quantitative Imaging in Medicine and Surgery

Paul Sagot³  Sylvain Favelier⁴  Frédéric Michel¹  Patricia Fauque⁵  Romaric Loffroy⁶  Aurélie Bertaut²  Louis Estivalet⁴  Nicolas Favard⁴  Morgan Moulin¹  Luc Cormier¹ 

[1] Department of Urology and Andrology,Department of Biostatistics, Georges François Leclerc Center, Dijon, France;Department of Gynaecology-Obstetrics, Fœtal Medicine and Sterility of Couple, François-Mitterrand Teaching Hospital, University of Dijon School of Medicine, Dijon Cedex, France;;Deparment of Vascular, Oncologic and Interventional Radiology,Laboratory of Biology of Reproduction, François-Mitterrand Teaching Hospital, University of Dijon School of Medicine, Dijon Cedex, France;;1Deparment of Vascular, Oncologic and Interventional Radiology,LE2I UMR CNRS 6306, Arts et Métiers, University of Bourgogne Franche-Comté, Dijon, France

关键词: Varicocele;    embolization;    cyanoacrylate glue;    coils;    polidocanol;   

DOI  :  10.3978/j.issn.2223-4292.2015.10.10

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: To evaluate pain, radiation and recurrence rates in patients undergoing varicocele embolization with three different embolic materials.

Methods: Retrospective study of 182 consecutive patients who underwent transcatheter retrograde varicocele embolization from July 2011 to May 2015 with glue (Glubran^®2) (group 1, n=63), mechanical agents (coils and/or plugs) (group 2, n=53) or a sclerosing agent (polidocanol) (group 3, n=66). Patients were asked by telephone interview to evaluate pain during embolization and at 1, 7 and 30 days using a quantitative pain scale ranging from 0 to 10. Duration of scopy, kinetic energy released per unit mass (kerma) and dose area product (DAP) were assessed as radiation parameters during embolization procedures. Recurrence rates after treatment were also evaluated. Statistical analyses were performed using parametric and non-parametric tests.

Results: Patients in the three study groups were comparable for age, clinical indication and embolization side. No difference was noted for significant pain (pain score �?3) during embolization and at 1, 7 and 30 days after treatment. Discomfort (pain score <3) was more frequent in group 1 than in groups 2 and 3 at 7 days after the procedure (P=0.049). No difference in discomfort was noted during embolization or at 1 and 30 days. Duration of scopy was shorter (P<0.0001) and kerma was lower (P=0.0087) in group 1 than in groups 2 and 3. DAP was lower in group 1 than in group 2 (P=0.04) but no difference was noted between groups 1 and 3, and groups 2 and 3. The recurrence rate at a mean follow-up of 24.4 months (range, 2-53 months) was significantly lower in group 1 than in the two other groups (P=0.032).

Conclusions: The use of Glubran^®2 acrylic glue for varicocele embolization is safe and leads to less radiation and lower recurrence rates than is the case for other embolic materials without any more significant pain.

【 授权许可】

Unknown