Case Report
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Jul 28, 2011; 3(7): 194-198
Published online Jul 28, 2011. doi: 10.4329/wjr.v3.i7.194
Antegrade pampiniform plexus venography in recurrent varicocele: Case report and anatomy review
Vyacheslav Gendel, Ihab Haddadin, John L Nosher
Vyacheslav Gendel, Ihab Haddadin, John L Nosher, Department of Radiology, UMDNJ, Robert Wood Johnson University Hospital, New Brunswick, NJ 08901, United States
Author contributions: Nosher JL was responsible for patient care; Haddadin I assisted with review of the literature; Nosher JL and Gendel V drafted the manuscript.
Correspondence to: Dr. Vyacheslav Gendel, Department of Radiology, UMDNJ, Robert Wood Johnson University Hospital, New Brunswick, NJ 08901, United States. vgendel@hotmail.com
Telephone: +1-732-2357721 Fax: +1-732-2356889
Received: March 2, 2011
Revised: May 20, 2011
Accepted: May 27, 2011
Published online: July 28, 2011
Abstract

Varicoceles are often treated with percutaneous embolization, using fibered coils and sclerosing agents, with the latter targeted at occlusion of pre-existing collateral veins. While various methods of surgical and embolization treatment are available, varicoceles may still recur from venous collateralization. We present a case, where following demonstration of complete occlusion of the right and left gonadal veins, direct puncture of the pampiniform venous plexus under ultrasound guidance revealed recurrent varicoceles supplied by anastomoses from the ipsilateral saphenous and femoral veins to the pampiniform plexus. In doing so, we describe a technique of percutaneous pampiniform venography in a case where the pertinent anatomy was not easily demonstrated by other methods.

Keywords: Varicocele; Embolization; Pampiniform plexus; Venography