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Updated: Jan 26, 2026
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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
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Management Options for Gastric Variceal Hemorrhage
Edward Wolfgang Lee1,2, Puja Shahrouki1, Lourdes Alanis1
1Division of Interventional Radiology, Department of Radiology, University of California at Los Angeles Medical Center, David Geffen School of Medicine at University of California, Los Angeles.
JAMA Surgery
|April 4, 2019
Summary
Balloon-occluded retrograde transvenous obliteration (BRTO) is a safe and effective treatment for gastric variceal bleeding. This minimally invasive procedure is gaining popularity for managing this serious complication of cirrhosis.
Area of Science:
- Interventional Radiology
- Hepatology
- Gastroenterology
Background:
- Gastric varices are a significant manifestation of cirrhosis and portal hypertension, often linked to a worse prognosis due to bleeding risk.
- Traditional treatments for gastric variceal bleeding have varied, with Western and Eastern approaches differing historically.
Purpose of the Study:
- To provide a comprehensive literature review of current and emerging management options for gastric varices.
- To highlight the growing role and effectiveness of Balloon-occluded retrograde transvenous obliteration (BRTO) in treating gastric variceal hemorrhage.
Main Methods:
- Literature review of management options for gastric varices.
- Focus on the evolution, safety, and efficacy of BRTO and modified BRTO.
- Comparison of Western and Eastern interventional radiology preferences for gastric variceal treatment.
Main Results:
- BRTO has evolved over 20 years, with decreased procedure-related risks.
- BRTO is recognized for its safety and efficiency in treating gastric varices.
- BRTO is increasingly adopted by Western interventional radiologists.
Conclusions:
- BRTO is a safe and effective alternative for gastric variceal hemorrhage.
- Multidisciplinary team approach, proper training, and evidence-based guidelines are crucial for optimal patient care with BRTO.
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