title: [Percutaneous sclerotherapy of a varicocele with atypical retrograde flow using a double-balloon occlusion technique].
abstract: OBJECTIVE
  To perform a double-balloon occlusion for selective sclerosis of the internal spermatic vein in a varicocele with atypical retrograde flow.
  
  
  METHODS
  In a 19-year-old man with a primary varicocele, phlebography demonstrated an 8-mm-wide internal spermatic vein with parallel collaterals and marked reflux of the contrast agent in the supine position. A single balloon occlusion could not prevent rapid wash-out of contrast material via collateral veins. Subsequently, two 8-mm balloon-catheters were sequentially inserted into the internal spermatic vein. After inflation of both balloons, the sclerosing agent was administered through the proximal catheter into the balloon-occluded venous segment.
  
  
  RESULTS
  Percutaneous sclerotherapy using the double-balloon technique achieved complete stasis inside the ectatic and retrograde perfused spermatic vein including its major parallel collaterals.
  
  
  CONCLUSIONS
  In primary varicocele with strong spontaneous reflux and complicated flow pattern of the collateral veins, the double-balloon occlusion technique can achieve high local concentration of the sclerosing agent at optimal position and without wash-out effects.
authors.affiliation: Klinik für Radiologische Diagnostik, Universitätsklinikum der RWTH Aachen.
authors.forename: C
authors.initials: C
authors.lastname: Nolte-Ernsting
authors.forename: H
authors.initials: H
authors.lastname: Schubert
authors.forename: R W
authors.initials: RW
authors.lastname: Günther
mesh_terms: D000328:Adult; D021721:Balloon Occlusion; D003097:Collateral Circulation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010690:Phlebography; D015911:Sclerotherapy / Q000379:methods*; D013997:Time Factors; D014646:Varicocele / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*