European radiology
October 8, 2026 · via Europe PMC
Comparison of transbrachial and transfemoral venous access in varicocele embolization: impact on radiation dose and technical success.
Odenthal AM, Böhner AMC, Dell T, Meyer C, Reinert M, Voigt M, Luetkens JA, Kupczyk PA.
AI summary — for doctors, generated from the abstract only
Transbrachial venous access for varicocele embolization was associated with lower radiation dose and shorter procedures than transfemoral access, with similar safety.
What was studied
Retrospective analysis of 247 embolization procedures (145 transbrachial, 102 transfemoral), compared with 1:1 propensity score matching, which produced 41 matched pairs.
Key findings
- Technical success was 95.1% transbrachial versus 82.9% transfemoral (p = 0.15, not significant)
- Transfemoral access had a 68% higher dose-area product (ratio 1.68, 95% CI 1.06-2.66), and longer fluoroscopy (+608 s) and procedure time
- No significant differences in overall or access-site complications
Clinical relevance
Because patients are typically young and healthy, lowering radiation exposure is meaningful, so transbrachial access may be a reasonable alternative for interventional radiologists.
Who should care
Limitations
Retrospective and non-randomized, and matching left only 41 pairs, so the technical success difference is imprecise and not statistically significant. Complication comparisons may be underpowered.
Transbrachial access appears to reduce radiation and procedure time without a safety penalty, pending prospective confirmation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objectives
This study evaluates the advantages of superficial venous transbrachial access compared to conventional transfemoral access in varicocele embolization, focusing on technical success and radiation dose reduction.
Materials and methods
A retrospective analysis was conducted on 241 patients in whom 247 varicocele embolization procedures were performed via transbrachial (n = 145, 58.7%) or transfemoral (n = 102, 41.3%) venous access. Procedural parameters, including radiation exposure (fluoroscopy time and dose-area product), technical success, material consumption, and complications, were compared using propensity score matching (1:1).
Results
Forty-one matched pairs of transbrachial and transfemoral accesses were analyzed. Technical success rates were similar between transbrachial (95.1%) and transfemoral access (82.9%, p = 0.15). Transfemoral access was associated with a significantly higher dose-area product (ratio of geometric means 1.68, 95% CI: 1.06-2.66, p = 0.032), corresponding to a 68% increase. Additionally, the transfemoral approach was associated with a significantly longer fluoroscopy time (+ 608 s, 95% CI: 28- 1188 s, p = 0.043) and procedural time (1:15 [0:59-1:33] vs 1:39 [1:00-2:05] h; p = 0.04). There were no significant differences in overall and access-site-related complications.
Conclusion
The transbrachial approach may reduce radiation exposure and potentially improve the technical success rate in varicocele embolization, particularly in bilateral embolization, while maintaining procedural safety. Given that this procedure is typically performed in young, otherwise healthy men, a transbrachial access should be considered as a beneficial alternative.
Key points
Question Radiation dose reduction is essential in varicocele embolization performed in young, healthy patients, but the impact of venous access site on radiation exposure and procedural performance remains unclear. Findings In varicocele embolization, transbrachial venous access resulted in lower radiation dose, procedural time, and material consumption, while potentially offering a slightly higher technical success rate. Clinical relevance Transbrachial venous access should be considered an appealing alternative to the transfemoral approach in varicocele embolization, as it is associated with reduced radiation exposure in a predominantly young and otherwise healthy patient population.
DOI
10.1007/s00330-026-12934-5
PMID
42850456
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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