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Updated: Oct 29, 2025

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
Published on: June 13, 2025
Balloon-occluded retrograde transvenous obliteration for treatment of gastric varices
Nobuo Waguri1, Akihiko Osaki2, Yusuke Watanabe2
1Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata 950-1197, Japan. waguri@hosp.niigata.niigata.jp.
Abstract:
Rupture of gastric varices (GVs) can be fatal. Balloon-occluded retrograde transvenous obliteration (BRTO), as known as retrograde sclerotherapy, has been widely adopted for treatment of GVs because of its effectiveness, ability to cure, and utility in emergency and prophylactic treatment. Simplifying the route of blood flow from GVs to the gastrorenal shunt is important for the successful BRTO. This review outlines BRTO indications and contraindications, describes basic BRTO procedures and modifications, compares BRTO with other GVs treatments, and discusses various combination therapies. Combined BRTO and partial splenic embolization may prevent exacerbation of esophageal varices and shows promise as a treatment option.
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