Retrograde venography during balloon-occluded retrograde transvenous obliteration of gastric varices

Abstract

Purpose: The purpose of this study was to evaluate changes in thrombosis in gastric varices.

Material and methods: Fourteen patients were studied who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) for gastric varices with a gastrorenal shunt. The B-RTO catheter was retained overnight in all patients. Balloon-occluded retrograde venography (B-RTV) was performed to evaluate the degree of thrombus formation. This evaluation was done twice during the overnight B-RTO procedure: A few hours after the procedure and on the following day. Investigated were the degree of thrombus formation observed by the first and second B-RTV, change in the degree of thrombus between the first and second B-RTV, and whether and how much sclerosing agent was administered on the second day.

Results: The first B-RTV showed entire or partial enhancement of the gastric varix in seven (50%) cases and complete or almost complete lack of enhancement in the remaining seven cases. In four of the former seven cases, the second B-RTV showed entire or partial enhancement of the gastric varix, and the sclerosing agent was added. However, in the remaining ten cases, enhancement was almost or completely lacking.

Conclusion: When complete thrombosis is shown on B-RTV obtained a few hours after B-RTO, the addition of a sclerotic agent would be unnecessary.

Keywords:

• Balloon-occluded retrograde transvenous obliteration
• gastric varices

Declaration of interest

The other authors have no conflicts of interest.

Funding

Dr. Chayama receives honoraria (more than 1,000,000 yen) or research funding (more than 2,000,000 yen) from MSD Co., Ltd., Tanabe Co., Ltd., Roche Co., Ltd., Toray Co., Ltd., Chugai Co., Ltd., Sumitomo Co., Ltd., Otuka Co., Ltd., and Daiichi-Sankyo Co., Ltd. Dr. Awai receives research funding (more than 2,000,000 yen) from Toshiba Medical Systems Co., Ltd.