title: Partial thrombosis of gastric varices after balloon-occluded retrograde transvenous obliteration: CT findings and endoscopic correlation.
abstract: OBJECTIVE
  The purpose of our study was to investigate the frequency and outcomes of partial thrombosis of gastric varices after balloon-occluded retrograde transvenous obliteration (BRTO).
  
  
  METHODS
  We reviewed retrospectively 69 consecutive patients with gastric varices who were followed-up for > 6 months after treatment with BRTO. All patients underwent contrast-enhanced CT and gastroscopy before and after BRTO. Imaging findings of gastric varices with particular attention to afferent veins, degree of thrombosis, and variceal changes were investigated.
  
  
  RESULTS
  On the basis of pretherapeutic CT images, gastric varices were classified into two types: simple (< 3 afferent veins) and complex (≥ 3 afferent veins). Initial follow-up CT showed complete thrombosis in 58 patients (84%) and partial thrombosis in 11 (16%). Partial thrombosis was observed more frequently in complex-type varices (25% vs 9%). No regrowth or recurrent varices were observed in completely thrombosed varices. Follow-up endoscopy showed regrowth of gastric varices at 6-24 months after BRTO in five patients; all of these were complex-type and partially thrombosed varices. All five recurrent varices were treated successfully with repeated BRTO.
  
  
  CONCLUSIONS
  Partial thrombosis after BRTO can occur in complex-type gastric varices, which have a higher risk of regrowth. Additional techniques that achieve complete thrombosis are required for long-term efficacy for complex-type gastric varices.
authors.affiliation: Department of Radiology, Oita University Faculty of Medicine, Hasama-machi, Japan. takajiry@med.oita-u.ac.jp
authors.forename: Ryo
authors.initials: R
authors.lastname: Takaji
authors.forename: Hiro
authors.initials: H
authors.lastname: Kiyosue
authors.forename: Shunro
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Mika
authors.initials: M
authors.lastname: Okahara
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tanoue
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Kondo
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D003287:Contrast Media; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015642:Radiology, Interventional; D012189:Retrospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media