[Difficulties in the treatment of symptomatic varicocele using percutaneous embolization: the circumaortic renal vein].

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.