Indications for embolic therapy of the left ISV include a varicocele associated with infertility, painful varicoceles, and a large varicocele in a child or adolescent with testicular atrophy or recurrent varicocele after previous
embolization or surgery. Indications for
embolization of a right ISV include a palpable varicocele associated with infertility and a recurrent or persistent left varicocele without apparent collaterals to the ISV, as demonstrated with left renal venography.