[Interventional radiology for portal hypertension. PTO.TIO].
Percutaneous transhepatic obliteration (PTO) and transileocolic vein obliteration (TIO) are techniques of interventional radiology for embolization of collaterals due to portal hypertension 1) We can obtain good results from the precise selection of these techniques in accordance with the patient's hemodynamics and general condition. 2) Endoscopic injection sclerotherapy (EIS) combined with PTO or TIO for esophageal varices proves to be superior in reliability and durability to EIS alone, and the time before retreatment is much longer when this combination therapy is used. 3) In the intractable EIS only cases, a distinct improvement in results and prognosis appears in using PTO or TIO and also in adding more EIS thereafter. 4) After treatment with EIS and PTO or TIO for cardiac varices, we obtain better results in the disappearance rate as well as in the recurrence rate compared with EIS alone. 5) Gastric varices disappear and hepatic encephalopathy due to porto-systemic shunt is improved after PTO or TIO or using these with balloon occluded retrograde transvenous obliteration (BRTO). Thus PTO and TIO would be analogous to surgical devascularization or ligation. Therefore it is concluded that the best results would be obtained with PTO or TIO with other nonsurgical treatments.
Tajiri
T
T
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Onda
M
M
Yamashita
K
K
Kim
D Y
DY
Umehara
M
M
Kojima
T
T
Matsuzaki
S
S
Kumazaki
T
T
D000368:Aged; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000628:therapy; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015911:Sclerotherapy