Related Experiment Video
Updated: Jan 28, 2026
04:09
Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
Published on: June 13, 2025
1.1K
Ischemic Stroke After Plug-Assisted Retrograde Transvenous Obliteration for Gastric Varices.
Abhimati Ravikulan1,2, Lavanya Pushparajah1,2, Hyukjoon Lee3,2
1Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand.
ACG Case Reports Journal
|January 26, 2026
Summary
Plug-Assisted Retrograde Transvenous Obliteration (PARTO) is an effective treatment for gastric varices, but a rare risk of stroke has been identified. This case highlights the need for careful patient selection and counseling regarding potential embolic events.
Area of Science:
- Interventional Gastroenterology
- Vascular Surgery
- Neurology
Background:
- Plug-Assisted Retrograde Transvenous Obliteration (PARTO) is a common treatment for bleeding gastric varices.
- It is preferred in patients at high risk for hepatic encephalopathy, where Transjugular Intrahepatic Portosystemic Shunt (TIPS) may be unsuitable.
- Current guidelines suggest PARTO and Balloon-Occluded Retrograde Transvenous Obliteration (B-RTO) are superior to TIPS for preventing rebleeding and reducing hepatic encephalopathy.
Related Concept Videos
01:22Formation of the Platelet Plug
9.1K
The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
9.1K
01:24Esophageal Varices-I: Introduction
1.4K
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
1.4K
01:28Esophageal Varices-II: Clinical Features and Management
547
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
547
01:16Gastric Motility
3.1K
Gastric motility is the coordinated contraction and relaxation of stomach muscles that convert ingested food into chyme, a semi-liquid substance ready for further digestion in the intestines. The process begins with the vagus nerve inducing the relaxation of the smooth muscles in the fundus and body of the stomach, allowing these regions to expand and accommodate up to approximately 1.5 liters of food and liquid.
Peristaltic Waves and Chyme Formation
Upon food entry, the stomach initiates...
Peristaltic Waves and Chyme Formation
Upon food entry, the stomach initiates...
3.1K
01:16Gastric Emptying
3.6K
Gastric emptying occurs when the stomach gradually releases chyme into the duodenum. When the stomach is distended, it triggers the release of gastrin, a hormone that promotes gastric acid secretion to aid in digestion. Additionally, stomach distension contributes to peristaltic waves that propel gastric contents toward the pyloric region. The gastroenteric reflex, on the other hand, primarily stimulates peristalsis in the intestines, facilitating the movement of contents further along the...
3.6K
01:26Gastric Phase of Digestion
3.3K
The gastric phase of digestion begins as soon as food enters the stomach. The incoming food bolus triggers neural and hormonal mechanisms, which last approximately 3 to 4 hours. During this phase, the stomach undergoes significant changes to prepare the food for further digestion and absorption.
When food enters the stomach, it stretches the stomach walls and activates stretch receptors. This triggers local reflexes of the enteric nervous system, mediated through the myenteric plexus. These...
When food enters the stomach, it stretches the stomach walls and activates stretch receptors. This triggers local reflexes of the enteric nervous system, mediated through the myenteric plexus. These...
3.3K