[Anatomic variations of the spermatic vein and endovascular treatment of left varicoceles: a pediatric series].
OBJECTIVE
To report on the high incidence of anatomical variants of the origin and course of the internal spermatic vein (ISV) discovered at the time of percutaneous embolization of left varicoceles in a pediatric population.


METHODS
We reviewed retrospectively the 65 cases of left varicocele treated by percutaneous embolization (grade II and III) in our institution between 1990 and 2000. The course of the left renal vein (LRV), the origin of the ISV, and the number of ISVs and their pathway were recorded in all cases, according to the Bähren classification.


RESULTS
In 37/65 (57%), the ISV was single and arose from a normal LRV (type I). The following variants were encountered: type V--circumaortic LRV 9/65 (14%); type IVb--intrarenal origin of ISV 8/65 (12%); type II--multiple ISV 5/65 (8%); and pelvic collaterals 6/65 (9%).


CONCLUSIONS
Venous anatomical variants are frequently encountered (43%) at the time of left varicocele embolization in children. Such variants often impose some adjustments to the technique of embolization and, at times, hamper the procedure.
Département d'imagerie médicale, Université de Montréal, Hôpital Sainte-Justine, Montréal, Qué. laurent_garel@ssss.gouv.qc.ca
Laurent
L
Garel
Josée
J
Dubois
Françoise
F
Rypens
Alain
A
Ouimet
Salam
S
Yazbeck
D000293:Adolescent; D002648:Child; D004621:Embolization, Therapeutic; D006801:Humans; D008297:Male; D010690:Phlebography; D012082:Renal Veins / Q000002:abnormalities; D012189:Retrospective Studies; D015911:Sclerotherapy; D013737:Testis / Q000098:blood supply*; D014646:Varicocele / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D014680:Veins / Q000002:abnormalities / Q000473:pathology