Fig. 3.

A 24-year-old man presenting with left-sided testicular pain and heaviness. Left varicocele was diagnosed on clinical evaluation and referred for embolization. Fluoroscopic contrast injection with catheter in the left renal vein (open white arrow) ( a ) shows reflux of contrast into left gonadal vein (solid white arrow). Open black arrow = renal collecting system. The gonadal vein was selected using glide wire and selective injection ( b ) showed the course of gonadal vein (arrow) into pelvis. ( c ) Digital subtraction venogram shows single gonadal vein with reflux of contrast into scrotum (arrow) without evidence of retroperitoneal collaterals. ( d ) Successful embolization using sandwich technique (coils–STS–coils–STS–coils), with cessation of flow within gonadal vein. STS, sodium tetradecyl sulfate.