CIRSE Insider: Why do you think this paper resonated with the editors? What aspect of the research are you most proud of?
Ní Mhíocháin de Grae: I think the paper resonated because it looks at varicocele embolization over a long period, with a mean follow-up of over eight years, while focusing on outcomes that are meaningful to patients. We looked beyond procedural success to assess recurrence, the need for re-intervention, and fertility outcomes.
The aspect I am most proud of is the patient involvement. We were able to speak directly to patients years after their procedures and ask about their symptoms, recurrence and fertility. That gave the study a much more patient-centred perspective than simply looking at procedural records. Where patients reported a recurrence, we invited them back for ultrasound to establish whether it was a true recurrence and, where appropriate, offered repeat treatment.
For me, that is one of the most valuable aspects of clinical research — making sure that we are measuring outcomes that matter to the people we are treating.
CIRSE Insider: Your study found no significant difference in outcomes according to the embolic material used. How do you think this finding could influence procedural choices in varicocele embolization?
Ní Mhíocháin de Grae: Our findings suggest that the choice of embolic material may be less important than previously thought, as we found no significant association between embolic agent and technical success, clinical success, recurrence, or need for re-intervention. We also found no significant difference in fertility outcomes according to the embolic material used.
I think this gives operators some flexibility in choosing an embolic agent based on their experience, the individual patient’s anatomy, and the resources available. It also raises an interesting question about whether adding a sclerosant to coils provides additional clinical benefit. In our cohort, we found no evidence of additional benefit.
CIRSE Insider: What do your results suggest about the role of embolization within the broader treatment pathway for varicocele?
Ní Mhíocháin de Grae: Our results support percutaneous embolization as an effective, durable treatment option for varicocele. We found a 96% technical success rate and a 93.75% clinical success rate, with a confirmed recurrence rate of 6.25% over long-term follow-up.
I was particularly interested in the fact that embolization was also successful in patients who had previously undergone unsuccessful surgical treatment. All seven patients with previous failed surgery were successfully treated with interventional radiology, with no reported recurrences.
I think these findings reinforce the role of embolization as an important minimally invasive option, both as a primary treatment and as a potential salvage treatment following failed surgery.
CIRSE Insider: What are you most looking forward to about CIRSE 2026, and what are you hoping to take away from the experience?
Ní Mhíocháin de Grae: I am really looking forward to sharing our work with the wider interventional radiology community. I am particularly excited about meeting other researchers and clinicians working in embolization and learning how new evidence is being translated into clinical practice.
I would also like to take away new ideas for future research. This study raised a number of interesting questions for me, particularly around long-term patient-centred outcomes and how we can continue to evaluate whether the technical choices we make during procedures genuinely make a difference to patients. Ultimately, I hope to use the experience to develop research that is both clinically relevant and focused on improving patient care.