title: Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) for Treatment of Gastric Varices: Review and Meta-Analysis.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis of the effectiveness and complications of BRTO for gastric varices.
  
  
  METHODS
  A systematic review was performed to identify relevant articles. Inclusion criteria were applied to select studies with at least ten patients with acute bleeding or at-risk gastric varices treated with BRTO. Meta-analysis with random effects model was performed to calculate data for immediate technical success, clinical success, and complications.
  
  
  RESULTS
  A total of 1,016 Patients from 24 studies met inclusion criteria. Technical success rate for BRTO was 96.4 % (95 % CI 93.7, 98.3 %; Q = 3,269.26, p < 0.01, I (2) = 99.39 %). Clinical success (defined as no recurrence or rebleed of gastric varices, or complete obliteration of varices on subsequent imaging) rate was 97.3 % (95 % CI 95.2, 98.8 %; Q = 3,105.91, p < 0.01, I (2) = 99.29 %). Major complication rate was 2.6 % (95 % CI 1.1, 4.6 %; Q = 3,348.98, p < 0.01, I (2) = 99.34 %). Esophageal variceal recurrence rate was 33.3 % (95 % CI 24.6, 42.6 %; Q = 7,291.75, p < 0.01, I (2) = 99.74 %).
  
  
  CONCLUSIONS
  BRTO is safe and efficacious for gastric varices, and current best evidence suggests that BRTO could be considered as therapy for patients with gastric varices.
authors.affiliation: UCLA Medical Center, Los Angeles, CA, USA.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Park
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Kee
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
authors.forename: Hyun J
authors.initials: HJ
authors.lastname: Kim
authors.forename: Francsico
authors.initials: F
authors.lastname: Durazo
authors.forename: Sung-Ki
authors.initials: SK
authors.lastname: Cho
authors.forename: Edward Wolfgang
authors.initials: EW
authors.lastname: Lee
mesh_terms: D021721:Balloon Occlusion / Q000009:adverse effects / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D006801:Humans; D011183:Postoperative Complications; D012008:Recurrence