title: [Difficulties in the treatment of symptomatic varicocele using percutaneous embolization: the circumaortic renal vein].
abstract: OBJECTIVE
  The anatomic anomalies of the inferior cava and its collaterals, even though they do not normally show symptoms, can cause difficulties in different diagnostic and therapeutic procedures, such as the percutaneous treatment by gonadal embolization of the varicocele.
  
  
  METHODS
  We analyzed the incidence of one of these anomalies, specifically the left circumaortic renal vein, in a series of 50 gonadal embolization procedures for symptomatic varicocele.
  
  
  RESULTS
  We found two cases (4%) of left circumaortic renal vein in our series. Gonadal embolization was possible in only one of the cases since the ostium of the gonadal vein could not be localized in the other case. In the first case, the gonadal ostium was in the paraaortic confluence of the venous ring, and could be catheterized and selectively embolized.
  
  
  CONCLUSIONS
  The presence of a circumaortic left renal vein can make it technically impossible to perform embolization of the symptomatic varicocele.
authors.affiliation: Unidad de Radiología Intervencionista del Servicio de Diagnóstico por Imagen, Hospital Clínico San Carlos, Madrid, España.
authors.forename: Eva
authors.initials: E
authors.lastname: Aguilar Rivilla
authors.forename: Enrique
authors.initials: E
authors.lastname: de la Peña Zarzuelo
authors.forename: Juan
authors.initials: J
authors.lastname: Gallego Beuter
authors.forename: Jose Vicente
authors.initials: JV
authors.lastname: Mendez Montero
authors.forename: Ernesto
authors.initials: E
authors.lastname: Santos Martín
authors.forename: Jose Angel
authors.initials: JA
authors.lastname: Delgado Martín
authors.forename: Jesús
authors.initials: J
authors.lastname: Blazquez Izquierdo
mesh_terms: D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000453:epidemiology; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D010690:Phlebography; D012082:Renal Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014646:Varicocele / Q000628:therapy*; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging