Balloon-occlusion catheter rupture during balloon-occluded retrograde transvenous obliteration of gastric varices utilizing sodium tetradecyl sulfate: incidence and consequences.
Balloon-occluded retrograde transvenous obliteration (BRTO) is an established procedure for the management of bleeding gastric varices in Asia. Invariably, the sclerosant utilized in Asia is ethanolamine oleate and the inventory used (vascular sheaths, balloon-occlusion catheters, and microcatheters) is not available outside Asia. A total of 41 BRTO procedures were performed with a technical and obliterative (gastric varix obliteration) success rate of 95% (n = 39 of 41) and 85% (n = 35 of 41), respectively. Complications were 4.9% (n = 2/41). A total of 6 balloon ruptures occurred (14.6%, n = 6 of 41). One rupture (16.7%, n = 1 of 6 of ruptures) lead to a technical failure and 2 ruptures (33.3%, n = 2 of 6 of ruptures) lead to an obliterative failure. Balloon rupture contributed to 50% of technical failures (n = 1/2, P = .274) and 33% of obliteration failures (n = 2/6, P = .148). In conclusion, the incidence of balloon-occlusion catheter rupture utilizing 3% sodium tetradecyl sulfate (STS) and inventory unique to the United States is significantly higher than in Asia (<8% rupture rate). However, these ruptures have no significant technical or clinical consequences.
Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA. wspikes@yahoo.com
Wael E A
WE
Saad
David
D
Nicholson
Allison
A
Lippert
Cynthia Cindy
CC
Wagner
Cenk U
CU
Turba
Saher S
SS
Sabri
Mark G
MG
Davies
Alan H
AH
Matsumoto
John Fritz
JF
Angle
D000293:Adolescent; D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000009:adverse effects / Q000295:instrumentation*; D057785:Catheters; D004867:Equipment Design; D004868:Equipment Failure; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy / Q000009:adverse effects / Q000295:instrumentation*; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage*; D017211:Treatment Failure; D014481:United States; D055815:Young Adult
D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate