title: Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance.
abstract: Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. onoyasy@hirakata.kmu.ac.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. kariyas@hirakata.kmu.ac.jp.
authors.forename: Shuji
authors.initials: S
authors.lastname: Kariya
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. nakatanm@hirakata.kmu.ac.jp.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Nakatani
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. yagir@hirakata.kmu.ac.jp.
authors.forename: Rie
authors.initials: R
authors.lastname: Yoshida
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. kohnoy@hirakata.kmu.ac.jp.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kono
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. kanna@takii.kmu.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kan
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. uenoyut@hirakata.kmu.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. komemush@takii.kmu.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Komemushi
authors.affiliation: Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. tanigano@hirakata.kmu.ac.jp.
authors.forename: Noboru
authors.initials: N
authors.lastname: Tanigawa
mesh_terms: D000369:Aged, 80 and over; D021721:Balloon Occlusion; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D012007:Rectum / Q000098:blood supply* / Q000000981:diagnostic imaging*; D015911:Sclerotherapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014648:Varicose Veins / Q000628:therapy*
keywords: Embolization; Portal Vein; Sclerotherapy; Transjugular intrahepatic portosystemic shunt; Varices; Venous intervention