Catheter-retaining balloon-occluded retrograde transvenous obliteration for gastric varices

We evaluated the effectiveness of catheter-retaining balloon-occluded retrograde transvenous obliteration (BRTO).

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.

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.

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.