Development of a new coaxial balloon catheter system for balloon-occluded retrograde transvenous obliteration (B-RTO).
OBJECTIVE
To develop a new coaxial balloon catheter system and evaluate its clinical feasibility for balloon-occluded retrograde transvenous obliteration (B-RTO).


METHODS
A coaxial balloon catheter system was constructed with 9 Fr guiding balloon catheter and 5 Fr balloon catheter. A 5 Fr catheter has a high flexibility and can be coaxially inserted into the guiding catheter in advance. The catheter balloons are made of natural rubber and can be inflated to 2 cm (guiding) and 1 cm (5 Fr) maximum diameter. Between July 2003 and April 2005, 8 consecutive patients (6 men, 2 women; age range 33-72 years, mean age 55.5 years) underwent B-RTO using the balloon catheter system. Five percent ethanolamine oleate iopamidol (EOI) was used as sclerosing agent. The procedures, including maneuverability of the catheter, amount of injected sclerosing agent, necessity for coil embolization of collateral draining veins, and initial clinical results, were evaluated retrospectively. The occlusion rate was assessed by postcontrast CT within 2 weeks after B-RTO.


RESULTS
The balloon catheter could be advanced into the proximal potion of the gastrorenal shunt beyond the collateral draining vein in all cases. The amount of injected EOI ranged from 3 to 34 ml. Coil embolization of the collateral draining vein was required in 2 cases. Complete obliteration of gastric varices on initial follow-up CT was obtained in 7 cases. The remaining case required re-treatment that resulted in complete obstruction of the varices after the second B-RTO. No procedure-related complications were observed.


CONCLUSIONS
B-RTO using the new coaxial balloon catheter is feasible. Gastric varices can be treated more simply by using this catheter system.
Tanoue
Shuichi
S
Department of Academic Radiology, Oita University Faculty of Medicine, Idaigaoka, 1-1, Hasama-machi, Oita-gun, Oita, 879-593, Japan. tanoue@med.oita-u.ac.jp
Kiyosue
Hiro
H
Matsumoto
Shunro
S
Hori
Yuzo
Y
Okahara
Mika
M
Kashiwagi
Junji
J
Mori
Hiromu
H
D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D003097:Collateral Circulation; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic; D004867:Equipment Design; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000008:administration & dosage; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D012597:Sclerosing Solutions / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media; D009829:Oleic Acids; D012597:Sclerosing Solutions; D007479:Iopamidol; C033343:ethanolamine oleate