Catheter-retaining balloon-occluded retrograde transvenous obliteration for gastric varices.
OBJECTIVE
We evaluated the effectiveness of catheter-retaining balloon-occluded retrograde transvenous obliteration (BRTO).


METHODS
Patients were divided into 2 groups based on concurrent contrast imaging findings. The primary endpoint was effectiveness, the secondary endpoint was complications, and the tertiary endpoint was recurrence of esophageal varices in all cases.


RESULTS
The mean volume of EO administered was 16.43 ± 4.37 overall and was significantly lower in group 1 (40.61 ± 14.95 mL; 15 patients, 32.6%) than in group 2 (31 patients, 67.4%). The number of injections was 1.60 ± 0.63 in group 1 and 2.97 ± 0.60 in group 2, and the volume of EO used in 1 day did not differ significantly between group 1 (12.28 ± 6.48 mL) and group 2 (13.54 ± 3.12 mL). The disappearance rate of varices was significantly greater in group 1 (100%) than in group 2 (90.3%). Fever developed in 33.3% of patients in group 1 and 87.1% of patients in group 2. The rates of recurrence of esophageal varices 2, 4, and 9 years after the procedure were 34%, 48%, and 57%, respectively.


CONCLUSIONS
These results show that catheter-retaining BRTO is a simple and highly effective procedure for difficult cases with minor complications. Furthermore, catheter-retaining BRTO does not require a large daily dose of EO and is, therefore, an effective treatment for solitary gastric varices.
Department of Hepatology and Gastroenterology, Tokyo Medical University.
Hiroshi
H
Kakutani
Jun
J
Sanada
Daiju
D
Nakayama
Fuminori
F
Moriyasu
D021721:Balloon Occlusion / Q000379:methods*; D057785:Catheters; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D009829:Oleic Acids / Q000008:administration & dosage*; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate