The combination of transarterial chemoembolization and microwave ablation is superior to microwave ablation alone for liver metastases from colorectal cancer.

OBJECTIVES: This study aimed to compare the combination therapy of transarterial chemoembolization (TACE) and microwave ablation (MWA) with MWA alone in treating liver metastases from colorectal cancer (LMCRC). MATERIALS AND METHODS: In this retrospective study, a total of 251 patients with unresectable and not to chemotherapy responding LMCRC were included. Group A consisted of 184 patients (104 male and 80 females; mean age: 64 ± 11.4 years) with 442 metastases who received a combination of TACE and MWA. A total of 67 patients (49 male and 18 females; mean age: 63.2 ± 11.8 years) with 173 metastases patients were included in group B, who received only MWA. Parameters assessed were local tumor progression (LTP), hepatic distant tumor progression (hDTP), hepatic progression-free survival (hPFS), and overall survival (OS). RESULTS: The rate of LTP was 4.9% in group A and 4.5% in group B (p-value: 0.062). The rate of hDTP was 71.7% and 83.6% for groups A and B (p-value: 0.81), respectively. The mean hPFS was 13.8 months (95% CI 10.9-16.8) for group A and 8.1 months (95% CI 6.1-10.1) for group B (p-value: 0.03). The median OS time for group A was 30 months (95% CI 26-34), with 1-, 2-, 3-, and 4-year OS rates of 84.2%, 61.1%, 40.8% and 31.3%, respectively. In group B however, the median OS time was 26 months (95% CI 18-34) with 1-, 2-, 3-, and 4-year OS rates of 82.3%, 53.2%, 34.6% and 28.2%, respectively (p-value: 0.67). CONCLUSION: The combination therapy of TACE and MWA is superior to the monotherapy of MWA for LMCRC, especially regarding hDTP, hPFS and OS.

Super-selective renal artery embolization (SRAE) for iatrogenic and traumatic renal hemorrhage.

PURPOSE: To present the radiological and clinical outcomes of super-selective transcatheter renal artery embolization in patients with renal injury hemorrhage, and share our experience. METHODS: 43 patients with renal injury hemorrhage who underwent 46 SRAEs were enrolled in this retrospective review study. Records, images, and outcomes were reviewed. The individual embolic method and its observed effects were investigated. RESULTS: Angiography showed free extravasation in 25 angiograms, pseudoaneurysm in 15 angiograms, and arteriovenous fistulas in 1 angiogram. Most patients achieved initial clinical success (38/43, 88.4%), and 41 patients achieved final clinical success (41/43, 95.3%). 9/11 patients who adopted empirical embolization achieved initial clinical success (81.8%). In our study, the combination of PVA particles and micro-coils has emerged as the most commonly utilized material combination (24/46, 52.2%). Significant differences in hemoglobin levels were observed before and after the embolization procedure (p = 0.026, 95%CI: 1.03-15.54). Post-embolization clinical follow-up showed no evidence of recurrent hematuria, progression of hematoma, hypertension, and no reflux of the embolic agent. CONCLUSION: Though SRAE showed satisfactory results across a broad range of renal injury hemorrhage, there are still some aspects that need attention: (1) Surgical procedure should be understood, including the surgical site, access routes, and placement of implants, such as double-J stents. (2) In cases where identifying the bleeding point proves challenging, consider the possibility of an accessory renal artery. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2400085050, Registration Date: 30 May 2024, retrospectively, non-randomized.

Damage Control Interventional Radiology: The bridge between non-operative management and damage control surgery.

Traumatic injuries continue to be on the rise globally and with it, the role interventional radiology (IR) has also expanded in managing this patient cohort. The role of damage control surgery (DCS) has been well established in the trauma management pathway, however it is only recently that Damage Control IR (DCIR) has become increasingly utilized in managing the extremis trauma and emergency patient.Visceral artery embolizations (both temporary and permanent), temporary balloon occlusions including Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in iliac arteries and aorta respectively are amongst the treatment options now available for the trauma (and non-traumatic bleeding) patient.We review the literature for the role of DCS and utilization of IR in trauma, outcomes and the paradigm shift towards minimally invasive techniques. The focus of this paper is to highlight the importance of multi-disciplinary working and having established pathways to ensure timely treatment of trauma patients as well as careful patient selection.We show that outcomes are best when both surgical and IR are involved in patient care from the outset and that DCIR should not be defined as Non-Operative Management (NOM) as it currently is categorized as.

Large Language Models for Simplified Interventional Radiology Reports: A Comparative Analysis.

PURPOSE: To quantitatively and qualitatively evaluate and compare the performance of leading large language models (LLMs), including proprietary models (GPT-4, GPT-3.5 Turbo, Claude-3-Opus, and Gemini Ultra) and open-source models (Mistral-7b and Mistral-8×7b), in simplifying 109 interventional radiology reports. METHODS: Qualitative performance was assessed using a five-point Likert scale for accuracy, completeness, clarity, clinical relevance, naturalness, and error rates, including trust-breaking and post-therapy misconduct errors. Quantitative readability was assessed using Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), SMOG Index, and Dale-Chall Readability Score (DCRS). Paired t-tests and Bonferroni-corrected p-values were used for statistical analysis. RESULTS: Qualitative evaluation showed no significant differences between GPT-4 and Claude-3-Opus for any metrics evaluated (all Bonferroni-corrected p-values: p = 1), while they outperformed other assessed models across five qualitative metrics (p < 0.001). GPT-4 had the fewest content and trust-breaking errors, with Claude-3-Opus second. However, all models exhibited some level of trust-breaking and post-therapy misconduct errors, with GPT-4-Turbo and GPT-3.5-Turbo with few-shot prompting showing the lowest error rates, and Mistral-7B and Mistral-8×7B showing the highest. Quantitatively, GPT-4 surpassed Claude-3-Opus in all readability metrics (all p < 0.001), with a median FRE score of 69.01 (IQR: 64.88-73.14) versus 59.74 (IQR: 55.47-64.01) for Claude-3-Opus. GPT-4 also outperformed GPT-3.5-Turbo and Gemini Ultra (both p < 0.001). Inter-rater reliability was strong (κ = 0.77-0.84). CONCLUSIONS: GPT-4 and Claude-3-Opus demonstrated superior performance in generating simplified IR reports, but the presence of errors across all models, including trust-breaking errors, highlights the need for further refinement and validation before clinical implementation. CLINICAL RELEVANCE/APPLICATIONS: With the increasing complexity of interventional radiology (IR) procedures and the growing availability of electronic health records, simplifying IR reports is critical to improving patient understanding and clinical decision-making. This study provides insights into the performance of various LLMs in rewriting IR reports, which can help in selecting the most suitable model for clinical patient-centered applications.

Cryoablation of osteoid osteomas: Is it a valid treatment option?

BACKGROUND: Osteoid osteoma is a benign bone tumor with characteristic clinical symptomatology. The selected method for its treatment is percutaneous radiofrequency ablation. However, percutaneous cryoablation is an alternative method with certain advantages. AIM: To evaluate percutaneous computed tomography (CT)-guided cryoablation for the treatment of osteoid osteoma in young patients and adults. METHODS: A total of 25 patients were treated with percutaneous CT- guided cryoablation for osteoid osteomas between October 2020 and March 2023 at a single institution. All patients were above 14-years-old (mean age, 24-years-old), and all procedures were performed under local anesthesia. Of the 25 patients, 8 were female and 17 were male. Tumor sites included the femur (n = 9), medial malleolus (n = 4), sacral ala (n = 4), facets (n = 4), humerus (n = 3), and tibia (n = 1). One cryoprobe was used in each procedure and, when possible, the lesion was covered by the ice-ball using an extraosseous position without penetrating the nidus. All necessary thermal protective techniques were used depending on the anatomical structure at risk. RESULTS: All patients treated had complete response (100% clinical success rate) starting on the day of the procedure. Technical success was achieved in all cases. Visual analog scale (VAS) scores at 1 year were 0, compared to a mean VAS score of 8.5 ± 1 (SD) before the procedure. No recurrences were reported at the 1-year follow-up and no complications were observed. In 11/25 cases, an extraosseous position of the cryoprobe was used with less procedural time achieving technical and clinical success and no complications with less patient discomfort. All patients were discharged from the hospital on the same day as the procedure. CONCLUSION: Cryoablation of osteoid osteomas is an efficacious and safe procedure with durable clinical results. Its greatest advantage is that the procedure can be performed under local anesthesia using an extraosseous position of the cryoprobe when possible.

Current role of interventional radiology in thyroid nodules.

Thyroid nodules are a prevalent health issue in society. Interventional radiological methods are successfully applied for both the diagnosis and treatment of nodules. Diagnostically, a fine-needle aspiration biopsy and a core needle biopsy can be performed to ascertain the benign or malignant nature of a lesion. In recent years, imaging-guided percutaneous treatment methods have become popular in the treatment of thyroid nodules. Aspiration, ablation, and embolization are techniques employed in the treatment process. In this study, we aimed to discuss the current role of interventional radiology in the diagnosis and treatment of thyroid nodules, which occupy an important place in clinical practice.

First Experience With Catheter-Directed Thrombolysis for Massive Pulmonary Embolism at Teaching Hospital Jaffna, Sri Lanka: A Case Report.

Catheter-directed thrombolysis (CDT) is one of the modes of treatment for massive pulmonary embolism (PE). This case report shares the new experience of CDT for massive PE at Teaching Hospital Jaffna, Sri Lanka. A 54-year-old woman developed massive PE two days after a traumatic tibial fracture. She was hemodynamically unstable with hypotension and hypoxemia. The multidisciplinary team decided to go for CDT, administering alteplase. Follow-up imaging demonstrated complete thrombus resolution and significant clinical improvement. This case emphasizes the efficacy and safety of CDT for massive PE, particularly in patients at high risk for bleeding. Our experience at Teaching Hospital Jaffna accentuates the significance of individualized treatment strategies and the adoption of advanced techniques in resource-limited settings.

Characteristics of the imaging diagnosis of alveolar echinococcosis.

Alveolar echinococcosis (AE) primarily manifests in the liver and exhibits characteristics resembling those of slow-growing malignant tumours. Untreated Echinococcus multilocularis infection can be lethal. By infiltrating the vascular systems, biliary tracts, and the hilum of the liver, it might lead to various problems. Due to its ability to infiltrate neighbouring tissues or metastasize to distant organs, AE can often be mistaken for malignancies. We present a concise overview of the epidemiological and pathophysiological characteristics of AE, as well as the clinical manifestations of the disease. This article primarily examines the imaging characteristics of AE using various imaging techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging, diffusion-weighted imaging, and virtual non-enhanced dual-energy CT. We additionally examined the contribution of radiography in the diagnosis, treatment, and monitoring of the condition.

Applications of artificial intelligence in interventional oncology: An up-to-date review of the literature.

Interventional oncology provides image-guided therapies, including transarterial tumor embolization and percutaneous tumor ablation, for malignant tumors in a minimally invasive manner. As in other medical fields, the application of artificial intelligence (AI) in interventional oncology has garnered significant attention. This narrative review describes the current state of AI applications in interventional oncology based on recent literature. A literature search revealed a rapid increase in the number of studies relevant to this topic recently. Investigators have attempted to use AI for various tasks, including automatic segmentation of organs, tumors, and treatment areas; treatment simulation; improvement of intraprocedural image quality; prediction of treatment outcomes; and detection of post-treatment recurrence. Among these, the AI-based prediction of treatment outcomes has been the most studied. Various deep and conventional machine learning algorithms have been proposed for these tasks. Radiomics has often been incorporated into prediction and detection models. Current literature suggests that AI is potentially useful in various aspects of interventional oncology, from treatment planning to post-treatment follow-up. However, most AI-based methods discussed in this review are still at the research stage, and few have been implemented in clinical practice. To achieve widespread adoption of AI technologies in interventional oncology procedures, further research on their reliability and clinical utility is necessary. Nevertheless, considering the rapid research progress in this field, various AI technologies will be integrated into interventional oncology practices in the near future.

Bilateral ovarian artery embolization for a symptomatic large cervical fibroid.

Uterine leiomyomas are one of the most common smooth muscle tumors in women. Cervical leiomyomas, in contrast, are a relatively rare entity with limited available information, presenting a challenge for determining optimal treatment. Uterine artery embolization of cervical leiomyomas has been previously explored and met with some success. However, it has been associated with complications such as expulsion or incomplete embolization. This case, however, describes a patient who presented with a large cervical fibroid and was successfully treated with bilateral ovarian artery embolization, resulting in decreased fibroid burden and resolution of the patient's symptoms. Previous reports have demonstrated successful ovarian artery embolization for uterine leiomyomas, but this approach has yet to be shown for a cervical leiomyoma. Given the challenge presented by cervical leiomyomas, this case emphasizes a unique anatomical variant and the embolization method, providing an alternative, less-invasive option for reducing patient disease burden.

Standard of care versus standard of care plus Ericksonian hypnosis for percutaneous liver biopsy: Results of a randomized control trial.

PURPOSE: The purpose of this study was to compare levels of pain and anxiety during percutaneous ultrasound-guided liver biopsy between patients receiving standard of care and those receiving standard of care plus the support of Ericksonian hypnosis. MATERIALS AND METHODS: This prospective, single-center, single-blind, randomized controlled superiority trial included 70 participants. Participants were randomly assigned to either the standard of care group and received oral anxiolytic medications with reassuring conversational support, or to the experimental group, and received Ericksonian hypnosis (i.e., conversational hypnosis) in addition to standard of care. The primary outcome was the level of pain experienced during the biopsy, measured on a 10-point visual analog scale (0 indicating no pain to 10 indicating excruciating pain). Secondary outcomes included anxiety level during the biopsy, pain level within one hour of the biopsy measured using the same 10-point visual analog scale, amount of analgesic medication taken in the 24 h following the biopsy, and patient willingness to undergo another ultrasound-guided percutaneous liver biopsy in the future. RESULTS: Thirty-six participants were included in the standard of care group, and 34 were included in the experimental group. The mean score of pain experienced during the biopsy was lower in the experimental group (2.4 ± 1.9 [standard deviation (SD)]) compared to the standard of care group (4.4 ± 2.6 [SD]) (P = 0.001). The level of anxiety experienced during the biopsy was lower in the hypnosis group (2.1 ± 1.8 [SD]) compared to the standard of care group (4.8 ± 2.4 [SD]) (P < 0.001). No significant differences in other secondary outcomes were observed between the two groups. CONCLUSION: The addition of Ericksonian hypnosis to standard of care reduces the pain experienced by patients during percutaneous ultrasound-guided percutaneous liver biopsy by comparison with standard of care alone.

Genicular artery embolisation versus sham embolisation for symptomatic osteoarthritis of the knee: a randomised controlled trial.

OBJECTIVE: To determine the efficacy of genicular artery embolisation (GAE) compared with sham GAE for pain reduction in patients with symptomatic mild-to-moderate knee osteoarthritis (KOA). DESIGN: Double-blind randomised sham-controlled clinical trial conducted from June 2019 to December 2021. The follow-up period was 4 months. SETTING: Single-centre study conducted at a university medical centre in Rotterdam, Netherlands. PARTICIPANTS: 58 adults with symptomatic mild-to-moderate KOA not improving with conservative treatment. INTERVENTIONS: Participants were randomised to receive either GAE treatment or a sham GAE treatment. MAIN OUTCOME MEASURES: The primary outcome was reduction of pain measured with the Knee Injury and Osteoarthritis Outcome Score pain subscale (0-100, with 0 representing the worst pain outcome and 100 the best) after 4 months. Outcomes were assessed at baseline and 1 and 4 months. RESULTS: From June 2019 to December 2021, 58 patients were included. 29 patients were randomised to the GAE group and 29 to the sham group. All participants completed the study. The mean pain reduction after 4 months was 21.4 (95% CI 13.9 to 28.8) for the GAE group and 18.4 points (95% CI 11.6 to 25.1) for the sham group. The between-group difference for the mean pain reduction was 3.0 (95% CI -7.1 to 13.0) with an estimated Cohen's d effect size of d = 0.15 (95% CI -0.37 to 0.66). Group allocation was not a significant contributor to pain reduction (p = 0.31). No serious adverse events (AEs) occurred. 23 mild AEs occurred in the GAE group and 5 in the sham group. CONCLUSION: We did not establish a clinical effect of GAE in patients with mild-to-moderate KOA as GAE produced a similar effect on pain reduction as a sham GAE procedure. TRIAL REGISTRATION NUMBER: NCT03884049.

"Trap technique": A new multimodal approach for the treatment of intracardiac foreign body retrieval.

In medical practice, the retrieval of intravascular foreign bodies (IFBs) represents a challenge and often requires a multidisciplinary approach. We report a case of a 65-year-old male patient with a metallic guide wire extended from the right subclavian artery to the left ventricle. An interventional radiology team employed the "trap technique", with a combination of a retrieval device and angiographic catheters, which results crucial in this case. Proper device management and imaging assessment are essentil to the successful retrieval of IFBs. Further research is warranted to refine IFB retrieval techniques and evaluate long-term outcomes.

A rare case of replaced right hepatic artery with direct aortic origin described angiographically during trans-arterial radioembolization.

Normal hepatic arterial anatomy consists of the right hepatic artery and left hepatic artery branching from the common hepatic artery. Despite this being the most common configuration, many variations have been described. Here, we present a rare variant of hepatic arterial anatomy- a replaced right hepatic artery with direct aortic origin. Additionally, the patient was found to have a dorsal pancreatic artery originating from the replaced right hepatic artery This was angiographically identified during mapping for transarterial radioembolization for hepatocellular carcinoma. The unique anatomy in this case and the effect it had on transarterial radioembolization planning described herein demonstrates the necessity of understanding variant hepatic arterial anatomy in endovascular hepatic interventions.

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a strategy for postpartum haemorrhage management: A narrative review.

Postpartum hemorrhage (PPH) remains one of the leading causes of maternal mortality worldwide, with a significant impact on global health. Optimal management of PPH involves distinct steps executed simultaneously by a multidisciplinary approach, with anesthesiologists playing a key role in hemodynamic control and patient resuscitation. In this context, an aortic blood flow interruption through an internal balloon should be considered a rescue option among the various opportunities, to treat or prevent abdominal hemorrhages. Given this perspective, there is increasing interest in the role of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), originally used in trauma and military medicine, which has emerged as a novel strategy for managing PPH. Indeed, this technique has shown promise in managing severe cases of PPH, especially where traditional measures are insufficient. It also offers potential as a prophylactic measure in pregnancies with high risk for PPH, such as in the case of placenta accrete spectrum. This review aims to examine the efficacy, safety, and potential applications of REBOA in PPH management and prevention. At the same time, challenges such as the need for skilled operators, potential complications, costs, and the consideration of fetal safety were also discussed. REBOA presents as a promising tool against PPH, with efficacy in reducing blood loss, preserving fertility, and potentially decreasing maternal mortality and improving outcomes. However, its implementation requires careful consideration, training, and further research to establish clear guidelines for its use in obstetric care.

Collapse of a cephalic arch stent: An atypical complication of hemodialysis vascular access.

Access dysfunction is a significant contributor to morbidity in hemodialysis patients. The cephalic arch is a common location of vascular stenosis, with a considerable risk of relapse. While covered stents demonstrated a higher patency rate when compared to percutaneous transluminal angioplasty, their placement has some issues. Stent collapse and guttering are well-documented in arteries but not in arteriovenous fistulas. This report describes an unusual case of a cephalic arch stent collapsing 1 month after its positioning, as evidenced by access dysfunction.

Use of the subcutaneous ureteral bypass device and urethral stenting for treatment of malignant urinary outflow tract obstructions in cats.

OBJECTIVES: The aim of this study was to describe the technical success and outcomes of ureteral and urethral decompression using the subcutaneous ureteral bypass (SUB) device and transurethral self-expanding metallic stents (SEMS) as a palliative treatment option for feline malignant urinary outflow tract obstructions. METHODS: A retrospective study was conducted of 14 cats with ureteral and/or urethral obstructions secondary to diagnosed or suspected transitional cell carcinoma (TCC). In all cats, a SUB device and/or a SEMS was placed to relieve the obstruction(s). Group 1 consisted of cats with ureteral obstructions, with or without concurrent urethral obstructions, and group 2 consisted of cats with only urethral obstructions. RESULTS: Eight cats were included in group 1 (seven with concurrent urethral obstructions) and six cats were included in group 2. TCC was confirmed in 8/14 cats. Repeat urethral obstruction due to tumor in growth occurred in 6/13 (46%) cats with a SEMS, and no cats developed recurrent ureteral obstructions after placement of the SUB device. Three cats had additional covered stents placed after urethral re-obstruction. The median survival time (MST) from the time of device placement was 52 days in group 1 (mean 92; range 14-349) and 80 days in group 2 (mean 96; range 7-209). The MST from the time of mass identification of the cats that did and did not receive adjunctive therapy was 349 days (mean 358; range 124-602) and 43 days (mean 113; range 14-423), respectively. CONCLUSIONS AND RELEVANCE: The use of bypass devices for feline malignant urinary outflow tract obstructions is a viable option to provide immediate renal and urinary bladder decompression. TCC in cats is locally aggressive and can result in urethral re-obstruction, prompting consideration for placing a covered urethral stent. The use of adjunctive therapies for malignant neoplasia should be considered to improve overall survival once the obstruction has been relieved.

Dysphagia as a manifestation in superior vena cava syndrome.

The differential diagnosis of dysphagia and dyspnoea with cervicofacial oedema is wide and includes diseases with variable prognosis that may require an urgent approach. This article presents the case of a middle-aged man who came to the emergency room referring to the symptoms described, with a history of central venous access established approximately 4 years ago. The patient was diagnosed with superior vena cava syndrome and treated with anticoagulants and removal of the catheter. After a week of admission with anticoagulation, the patient clinically improved with a considerable decrease in thrombus and pharyngolaryngeal and subcutaneous mucosal oedema. In the differential diagnosis of dysphagia and dyspnoea, we must also consider systemic diseases, and more specifically, these symptoms such as those described, and think about this entity because of its severity.

Bridging Visual-Spatial Ability and Skill Performance: The Impact of Perceived Quality of a Practical Seminar in Interventional Radiology Education.

BACKGROUND: Medical education integrates skills training and simulation to prepare students for clinical tasks. A seminar on interventional radiology was restructured to include specific practical training utilizing a 3D-catheter model. We aimed to investigate the complex interplay between student evaluations, their visual-spatial ability and practical performance. METHODS: The seminar comprised a short plenary introduction followed by 3 practical training units. Students were tested for their visual-spatial ability and their catheter insertion performance. Students rated the seminar and their interest in the subject. Data were subjected to descriptive, factorial, regression, and moderating analysis. RESULTS: A total of 141 medical students enrolled in the seminar. They attributed a high didactic and practical quality and expressed great interest in the subject. Male students outperformed females in the cube perspective test. In the practical examination, males needed significantly less time on average (57.9 s) compared to females (73.1 s). However, there were no significant differences in the performance score, with a maximum of 5 attainable points: males 4.61 and females 4.51. The seminar evaluation explained a large portion of the variance (48.6%) in students' interest in the subject. There was a moderating role of practical quality (ß = 0.12, P < .05) on the link between the cube perspective test and the practical examination: rated high practical quality could partly compensate for low cube perspective scores, enhancing performance in the practical examination. CONCLUSIONS: Well-designed practical courses and a perceived high teaching quality may assist students with deficits in visual-spatial ability to acquire clinical-practical skills. Such initiatives not only enhance learning outcomes across diverse student groups but also stimulate interest in specialized fields like interventional radiology, thereby potentially guiding future career paths in medicine.

Varicocele and Interventional Radiology: A Comprehensive Case Study on Diagnosis, Therapeutic Intervention, and Implications for Reproductive Health.

Male infertility is known to be influenced by varicocele, a common vascular aberration marked by aberrant dilatation of the pampiniform plexus veins within the scrotum. In this instance, a 38-year-old man showed up with scrotal discomfort and swelling, which are clinical signs of varicocele. Scrotal ultrasonography provided diagnostic confirmation, confirming the existence of varicocele and identifying a concomitant minor hemorrhage in the left scrotal sac. Despite the initiation of conservative measures, such as bed rest, cryotherapy, and analgesics, the patient's clinical course was marked by persistent scrotal swelling and hematoma formation. Subsequently, interventional radiological techniques were employed, specifically coil deployment and varicocele embolization. These interventions demonstrated significant efficacy, leading to a notable reduction in the presenting symptoms. Follow-up assessments, conducted post intervention, indicated a complete resolution of both pain and hematoma. This clinical trajectory underscores the pivotal role of interventional radiology in managing varicocele-related complications. The multi-faceted nature of this case highlights the necessity of a comprehensive, inter-disciplinary approach integrating radiological interventions for the effective management of varicocele-associated symptoms, potentially optimizing reproductive health outcomes.