title: Factors related to thrombosis of gastric varix during balloon-occluded retrograde transvenous obliteration.
abstract: BACKGROUND
  Balloon-occluded retrograde transvenous obliteration (B-RTO) has become known as an effective treatment for gastric varices with a gastrorenal shunt. However, the appropriate duration to maintain inflation of the catheter balloon for sufficient thrombosis has been unknown.
  
  
  OBJECTIVE
  To evaluate retrospectively the factors related to the development of thrombus in gastric varices by evaluating the necessity of the addition of a sclerosing agent on the second day in overnight B-RTO.
  
  
  METHODS
  Sixty-five patients who underwent B-RTO for gastric varices with a gastrorenal shunt were studied. The B-RTO catheter was retained overnight in all patients. Incidence of and factors influencing the necessity of additional injections of a sclerosing agent on the second day were investigated.
  
  
  RESULTS
  In all 65 patients (100%), B-RTO was technically successful and in 61 patients (93.8%) complete thrombosis of the gastric varices was achieved. In 46 of the 65 patients (70.8%), the sclerosing agent was added on the second day. Higher Child-Pugh score, in particular, lower serum albumin level, and higher prothrombin time-international normalized ratio (PT-INR) were significantly associated with the need for the addition of the sclerosing agent on the second day. Optimal cut-off values for the serum albumin level and PT-INR were 3.6 g/dL and 1.13, respectively.
  
  
  CONCLUSIONS
  Liver function might influence the development of thrombosis of gastric varices in B-RTO. Serum albumin and PT-INR levels would provide information for deciding on the duration of retention of the B-RTO catheter to obtain sufficient therapeutic effectiveness.
authors.affiliation: Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan rika442@hiroshima-u.ac.jp.
authors.forename: Rika
authors.initials: R
authors.lastname: Yoshimatsu
authors.affiliation: Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miura
authors.affiliation: Department of Radiology, Fukuchiyama City Hospital, Kyoto, Japan.
authors.forename: Mitsuoki
authors.initials: M
authors.lastname: Hashiba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time / Q000379:methods; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use; D012709:Serum Albumin; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions; D012709:Serum Albumin; D007479:Iopamidol
keywords: Balloon-occluded retrograde transvenous obliteration; gastric varices