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Catheter-retaining Balloon-occluded Retrograde Transvenous Obliteration for Gastric Varices
Department of Hepatology and Gastroenterology, Tokyo Medical University
Purpose: We evaluated the effectiveness of catheter-retaining balloon-occluded retrograde transvenous obliteration (BRTO).
Patients and 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.
Conclusion: 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.
J Nippon Med Sch 2014; 81: 298-304
Keywords
balloon-occluded retrograde transvenous obliteration, catheter-retaining balloon-occluded retrograde transvenous obliteration, gastric varices, ethanolamine oleate
Correspondence to
Hiroshi Kakutani, Department of Gastroenterology and Hepatology, Hachioji Medical Center, Tokyo Medical University, Tatemachi 1163, Hachioji City, Tokyo 193-0944, Japan
kakutani@tokyo-med.ac.jp
Received, October 19, 2013
Accepted, January 10, 2014
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