Double-balloon (CANDIS) Retrograde Transvenous Obliteration Improves Hepatic Functional Reserve Compared with the...

Area of Science:

• Interventional Radiology
• Hepatology
• Gastroenterology

Background:

• Conventional balloon-occluded retrograde transvenous obliteration (B-TIPS) for gastric varices can have variable outcomes due to complex collateral drainage.
• A novel cooperative anti-reflux and double interruption system (dual-balloon device) was developed to enhance venous occlusion stability.

Purpose of the Study:

• To evaluate the clinical and hepatic functional benefits of dual-balloon B-TIPS using the cooperative anti-reflux and double interruption system.
• To compare the dual-balloon method against the conventional single-balloon method for treating gastric varices.

Main Methods:

• A single-center retrospective study included 48 patients with gastric varices undergoing B-TIPS.
• Eighteen patients received the single-balloon method, and 30 underwent the dual-balloon procedure.
• Clinical success, technical success, complications, and hepatic function (Child-Pugh, albumin-bilirubin scores) were assessed up to 12 months post-procedure.

Main Results:

• Clinical success rates were significantly higher with the dual-balloon system (90.0%) compared to the single-balloon method (50.0%, p = 0.004).
• Hepatic function improved significantly in the dual-balloon group, with marked decreases in albumin-bilirubin and Child-Pugh scores (p < 0.05).
• Technical success rates were high in both groups (100% vs. 88.9%), and complication rates were comparable.

Conclusions:

• Dual-balloon B-TIPS using the cooperative anti-reflux and double interruption system offers a safe and effective treatment for gastric varices.
• This method significantly improves clinical outcomes and long-term hepatic function compared to conventional single-balloon techniques.
• The dual-balloon approach provides stable occlusion and uniform sclerosant distribution, ensuring reliable results even in complex cases.