Balloon-occluded retrograde transvenous obliteration of gastric varix with multiple drainage veins performed with temporal occlusion of the pericardiacophrenic vein with a micro-balloon.
We encountered a case with a gastric varix that drained into the gastro-renal shunt, left pericardiacophrenic vein, and several other dilated collateral veins. This patient had a circumaortic venous ring. For this case we successfully performed balloon-occluded retrograde transvenous obliteration in which sclerotic agents were infused from the balloon catheter advanced to the left pre-aortic renal vein and the tip was wedged into the end of the gastro-renal shunt. Before injection of sclerotic agents, collateral veins other than the left pericardiacophrenic vein were embolized with micro-coils. During the injection, the left pericardiacophrenic vein was occluded temporarily with a micro-balloon catheter coaxially advanced from the catheter inserted from the femoral vein to the left pericardiacophrenic vein through the left brachiocephalic vein.
Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Takuji
T
Yamagami
Department of Radiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
Makoto
M
Iida
Department of Radiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
Nobuko
N
Tanitame
Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Rika
R
Yoshimatsu
Department of Radiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
Chiaki
C
Ono
Department of Gastroenterology, Hiroshima City Asa Hospital, Hiroshima, Japan.
Koji
K
Waki
Department of Gastroenterology, Hiroshima City Asa Hospital, Hiroshima, Japan.
Keiji
K
Tsuji
Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Kazuo
K
Awai
Balloon-occluded retrograde transvenous obliteration; circumaortic venous ring; gastric varix; pericardiacophrenic vein