title: Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices.
  
  
  METHODS
  Between February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44-86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6-33 mL). Patients were followed up using computed tomography (CT) or endoscopy.
  
  
  RESULTS
  Technical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality.
  
  
  CONCLUSIONS
  BRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.
authors.affiliation: Department of Radiology, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Il Soo
authors.initials: IS
authors.lastname: Chang
authors.affiliation: Department of Radiology, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Won Hyeok
authors.initials: WH
authors.lastname: Choe
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Young Koog
authors.initials: YK
authors.lastname: Cheon
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Chan Sup
authors.initials: CS
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Tae Yoon
authors.initials: TY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul 05030, Korea.
authors.forename: Jeong Han
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion; D003287:Contrast Media / Q000737:chemistry*; D003710:Demography; D004621:Embolization, Therapeutic; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D015911:Sclerotherapy; D012981:Sodium Tetradecyl Sulfate / Q000737:chemistry*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D012981:Sodium Tetradecyl Sulfate
keywords: Balloon-occluded retrograde transvenous obliteration; Gastric varices; Portal hypertension; Sodium tetradecyl sulfate