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Purpose <p>This study investigated the long-term efficacy of n-butyl-2-cyanoacrylate-metacryloxysulpholane (NBCA-MS) for varicocele embolization (VE) without using a microcatheter.</p> Methods <p>A retrospective study was conducted on male patients who underwent VE with NBCA-MS for grade III-IV varicocele between January 2016 and December 2022. Patients were categorized by the catheter type used. Telephone interviews assessed long-term effectiveness, focusing on relapse, re-treatment and spermiogram improvements.</p> Results <p>Of 185 patients, 102 completed the phone interview (median age 25&#xa0;years, median follow-up 4.1&#xa0;years). Sixty-six procedures were performed with only an HH1 catheter (Group A, 65%), and 36 required an additional microcatheter (Group B, 35%), with Group A having a shorter median procedure time (30 vs. 36.5&#xa0;min, p = 0.004). Long-term follow-up indicated a low recurrence rate (12%) and spermiogram improvement among a subset of patients (81%), with no significant difference in long-term efficacy between groups (relapse p = 0.244, re-treatment p = 1). Costs increased by 47–56% when adding a microcatheter plus a 0.018-inch guidewire.</p> Conclusion <p>The study confirms the effectiveness and safety of VE with NBCA-MS, demonstrating low recurrence rates and improvements in groin discomfort and fertility outcomes. In most cases of varicocele embolization using NBCA-MS, microcatheters can be avoided, reducing procedural costs and duration without compromising long-term efficacy.</p>

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Long-term efficacy and catheter choice in male varicocele embolization using NBCA-MS glue

  • 期刊论文

  • 发表日期：

    2024年12月31日

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  • Ezio Lanza,
  • Alessandra Mininni,
  • Luigi Tomasino,
  • Angela Ammirabile,
  • Giuseppe Ferrillo,
  • Silvio Romano,
  • Dario Poretti,
  • Marco Francone,
  • Vittorio Pedicini

摘要

Purpose

This study investigated the long-term efficacy of n-butyl-2-cyanoacrylate-metacryloxysulpholane (NBCA-MS) for varicocele embolization (VE) without using a microcatheter.

Methods

A retrospective study was conducted on male patients who underwent VE with NBCA-MS for grade III-IV varicocele between January 2016 and December 2022. Patients were categorized by the catheter type used. Telephone interviews assessed long-term effectiveness, focusing on relapse, re-treatment and spermiogram improvements.

Results

Of 185 patients, 102 completed the phone interview (median age 25 years, median follow-up 4.1 years). Sixty-six procedures were performed with only an HH1 catheter (Group A, 65%), and 36 required an additional microcatheter (Group B, 35%), with Group A having a shorter median procedure time (30 vs. 36.5 min, p = 0.004). Long-term follow-up indicated a low recurrence rate (12%) and spermiogram improvement among a subset of patients (81%), with no significant difference in long-term efficacy between groups (relapse p = 0.244, re-treatment p = 1). Costs increased by 47–56% when adding a microcatheter plus a 0.018-inch guidewire.

Conclusion

The study confirms the effectiveness and safety of VE with NBCA-MS, demonstrating low recurrence rates and improvements in groin discomfort and fertility outcomes. In most cases of varicocele embolization using NBCA-MS, microcatheters can be avoided, reducing procedural costs and duration without compromising long-term efficacy.