title: Long-term outcome of patients with gastric varices treated by balloon-occluded retrograde transvenous obliteration.
abstract: OBJECTIVE
  To assess the short- and long-term outcome of patients with gastric varices (GV) after balloon-occluded retrograde transvenous obliteration (B-RTO) by comparing bleeding cases with prophylactic cases.
  
  
  METHODS
  Consecutive 100 patients with GV treated by B-RTO were enrolled in this retrospective cohort study. We compared the technical success, complications, and survival rates between bleeding and prophylactic cases.
  
  
  RESULTS
  Of 100 patients, 61 patients were bleeding cases and 39 patients were prophylactic cases. Technical success was achieved in 95% of bleeding case and in 100% of prophylactic case, with no significant difference between these groups (overall technical success rate, 97%). The survival rates at 5 and 10 years were 50% and 22% in bleeding case, and 49% and 36% in prophylactic case, respectively. There was also no significant difference (P = 0.420). By multivariate analysis, survival rates correlated significantly with liver function (hazard ratio 2.371, 95% CI 1.457-3.860, P = 0.001) and hepatocellular carcinoma development (HR 4.782, 95% CI 2.331-9.810, P < 0.001). The aggravating rates of esophageal varices (EV) were 21%, 50%, and 54% at 12, 60, and 120 months after B-RTO. By multivariate analysis, aggravating rates significantly correlated with EV existing before B-RTO (HR 18.114, 95% CI 2.463-133.219, P = 0.004).
  
  
  CONCLUSIONS
  B-RTO for GV could provide the high rate of complete obliteration and favorable long-term prognosis even in bleeding cases as well as prophylactic cases. Management of EV after B-RTO, especially in coexisting case of GV and EV, would be warranted.
authors.affiliation: Department of Gastroenterology and Metabolism, Hiroshima University Hospital.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Naeshiro
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kan
authors.forename: Hatsue
authors.initials: H
authors.lastname: Fujino
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Yohji
authors.initials: Y
authors.lastname: Honda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohno
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyaki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hiraga
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000368:Aged; D021721:Balloon Occlusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: B-RTO; gastric varices; portal hypertension; prognosis esophageal varices