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Balloon-occluded retrograde transvenous obliteration for gastric varices: a feasibility study
1Department of Radiology, Wakayama Medical College, 27 Banchi, 7 Bancho, Wakayama City 640, Japan.
Purpose:
To evaluate the clinical feasibility of balloon-occluded retrograde transvenous obliteration (BORTO) for gastric varices.
Methods:
BORTO was performed in 14 patients with gastric varices due to liver cirrhosis. The gastric varices were confirmed by endoscopy, and their feeding and draining veins were identified by contrast-enhanced computed tomography (CT) and angiography. A 6 Fr Simmons-shaped balloon catheter was inserted into the gastrorenal shunt. The balloon was inflated, and 5% ethanolamine oleate iopamidol was infused slowly through the catheter. Patients were followed up with endoscopy and enhanced CT at 1 week, 1, 3, and 6 months after the procedure and every 6 months thereafter.
Results:
The gastric varices completely disappeared in 12 of 14 patients and was partially resolved in the remaining 2 patients. Neither a recurrence nor an aggravation of gastric varices were found. No major complications were experienced.
Conclusion:
BORTO is a safe and effective treatment for gastric varices.