top of page

BackTable / VI / Topic / Procedure

Varicocele Embolization

Varicocele Embolization Procedure & Complications

Learn more on the BackTable VI Podcast

BackTable is a knowledge resource for physicians by physicians. Get practical advice on Varicocele Embolization and how to build your practice by listening to the BackTable VI Podcast, reading exclusing BackTable Articles, and following the work of our Contributors.

Ep 102 Pelvic Congestion Syndrome Part 2: Technique and Follow-Up with Dr. Mark Meissner and Dr. Michael Cumming
00:00 / 01:04
BackTable CMEfy button

Stay Up To Date



Sign Up:

Varicocele Embolization Pre-Procedure Prep


Varicocele with pain, testicular atrophy, and/or infertility.


• Competent internal spermatic vein valve.
• Non-symptomatic varicocele

Things to Check

• Prior imaging - US/MRI
• Sudden onset of any varicocele, or an isolated right varicocele should prompt imaging of the retroperitoneum to exclude an abdominal or renal mass.

Varicocele Embolization Podcasts

Listen to leading physicians discuss varicocele embolization on the BackTable VI Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Episode #102


In Part 2 of their Pelvic Congestion Syndrome discussion, Dr. Mark Meissner and Dr. Michael Cumming get into their specific techniques, tips and tricks for embolization, and follow up care.

BackTable CMEfy button

Varicocele Embolization Procedure

Right Femoral or IJ Access

• 7 Fr. sheath from the groin, or 5 Fr if accessing from the neck.
• Cannulate the left renal vein and internal spermatic vein.
• Test the internal spermatic vein orifice for reflux under Valsalva with contrast injection.
• Advance catheter or microcatheter (to avoid vasospasm) into the distal gonadal vein.
• Can occlude the entire vein with coils, or a combination of coils, sotradecol, and/or Amplatzer plugs.
• First coils placed at the level of the inguinal canal/superior pubic ramus.
• Limit flow of sclerosant into the scrotum to avoid pampiniform plexus phlebitis via manual pressure or distal coil placement.

Post Varicocele Embolization Procedure


• Technical success in 90-97%
• Recurrence rate 2-12%

Potential Varicocele Embolization Complications

• Left renal vein thrombosis
• Pampiniform plexus thrombophlebitis
• Treatment failure. Symptoms persist.

Varicocele Embolization Demos

Watch video walkthroughs of varicocele embolization on the BackTable VI expanded content network.


[1] Rogers, P., Roberts, A., & Wong, W. (2002). Pocket Radiologist: Interventional Top 100 Diagnoses (1st ed.). AMIRSYS.
[2] Halpern, J., Mittal, S., Pereira, K., Bhatia, S., & Ramasamy, R. (2016). Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications. Asian Journal of Andrology, 18(2), 234.;year=2016;volume=18;issue=2;spage=234;epage=238;aulast=Halpern

Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.



Pelvic Congestion Syndrome Part 2: Technique and Follow-Up with Dr. Mark Meissner and Dr. Michael Cumming on the BackTable VI Podcast)
Iliofemoral Stenting: Decision-Making & Best Practices Explored with Dr. Kush Desai and Dr. Steven Abramowitz on the BackTable VI Podcast)



Related Topics

bottom of page