title: Three benefits of microcatheters for retrograde transvenous obliteration of gastric varices.
abstract: OBJECTIVE
  To evaluate the usefulness of the microcatheter techniques in balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices.
  
  
  METHODS
  Fifty-six patients with gastric varices underwent BRTOs using microcatheters. A balloon catheter was inserted into gastrorenal or gastrocaval shunts. A microcatheter was navigated close to the varices, and sclerosant was injected into the varices through the microcatheter during balloon occlusion. The next morning, thrombosis of the varices was evaluated by contrast enhanced computed tomography (CE-CT). In patients with incomplete thrombosis of the varices, a second BRTO was performed the following day. Patients were followed up with CE-CT and endoscopy.
  
  
  RESULTS
  In all 56 patients, sclerosant was selectively injected through the microcatheter close to the varices. In 9 patients, microcoil embolization of collateral veins was performed using a microcatheter. In 12 patients with incomplete thrombosis of the varices, additional injection of sclerosant was performed through the microcatheter that remained inserted overnight. Complete thrombosis of the varices was achieved in 51 of 56 patients, and the remaining 5 patients showed incomplete thrombosis of the varices. No recurrence of the varices was found in the successful 51 patients after a median follow up time of 10.5 mo. We experienced one case of liver necrosis, and the other complications were transient.
  
  
  CONCLUSIONS
  The microcatheter techniques are very effective methods for achieving a higher success rate of BRTO procedures.
authors.affiliation: Department of Radiology, Wakayama Medical University, Wakayama 641-8510, Japan. sonomura@wakayama-med.ac.jp
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Sonomura
authors.forename: Wataru
authors.initials: W
authors.lastname: Ono
authors.forename: Morio
authors.initials: M
authors.lastname: Sato
authors.forename: Shinya
authors.initials: S
authors.lastname: Sahara
authors.forename: Kouhei
authors.initials: K
authors.lastname: Nakata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sanda
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Minamiguchi
authors.forename: Motoki
authors.initials: M
authors.lastname: Nakai
authors.forename: Kazushi
authors.initials: K
authors.lastname: Kishi
mesh_terms: D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D057785:Catheters; D004932:Esophageal and Gastric Varices / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D012597:Sclerosing Solutions / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D012597:Sclerosing Solutions