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Balloon-occluded retrograde transvenous obliteration using a microballoon catheter for intractable gastric fundal varices.
J Gastroenterol Hepatol. 2014 Feb; 29(2):365-71.JG

Abstract

BACKGROUND AND AIM

Balloon-occluded retrograde transvenous obliteration (B-RTO) is recognized as the standard therapy for patients with gastric fundal varices in Japan; however, the procedure is difficult when drainage veins other than the gastrorenal shunt developed. The efficacy and safety of B-RTO using a microballoon catheter for such patients were evaluated.

METHODS

The subjects were 99 patients with gastric fundal varices who fulfilled the criteria for receiving endoscopic and/or interventional therapies. Among these, 95 patients underwent B-RTO. Of the 95 patients, 14 were treated with the use of microballoon catheters, including nine in whom the left inferior phrenic vein was found as a secondary drainage vein in addition to the gastrorenal shunt, and five in whom a gastrorenal shunt was absent. The B-RTO procedure performed using a microballoon catheter inserted through the left inferior phrenic vein in 13 patients, and through the pericardiophrenic vein in one patient.

RESULTS

The B-RTO procedure using microballoon catheters was successful in 13 of the 14 patients (93%), while in the remaining one patient, multiple drainage veins were visualized on venography. Complete obliteration of the varices was achieved in all the 13 patients by injection of 5% ethanolamine oleate iopamidol at a median volume of 25 mL (range, 11 to 40 mL) through the catheters. None of the patients showed injuries of the drainage veins or any systemic complications.

CONCLUSIONS

B-RTO using a microballoon catheter is useful for the treatment of gastric fundal varices in which drainage veins other than the gastrorenal shunt developed.

Authors+Show Affiliations

Gastroenterology & Hepatology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

23927078

Citation

Imai, Yukinori, et al. "Balloon-occluded Retrograde Transvenous Obliteration Using a Microballoon Catheter for Intractable Gastric Fundal Varices." Journal of Gastroenterology and Hepatology, vol. 29, no. 2, 2014, pp. 365-71.
Imai Y, Nakazawa M, Ando S, et al. Balloon-occluded retrograde transvenous obliteration using a microballoon catheter for intractable gastric fundal varices. J Gastroenterol Hepatol. 2014;29(2):365-71.
Imai, Y., Nakazawa, M., Ando, S., Sugawara, K., Hamaoka, K., Oka, M., & Mochida, S. (2014). Balloon-occluded retrograde transvenous obliteration using a microballoon catheter for intractable gastric fundal varices. Journal of Gastroenterology and Hepatology, 29(2), 365-71. https://doi.org/10.1111/jgh.12351
Imai Y, et al. Balloon-occluded Retrograde Transvenous Obliteration Using a Microballoon Catheter for Intractable Gastric Fundal Varices. J Gastroenterol Hepatol. 2014;29(2):365-71. PubMed PMID: 23927078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Balloon-occluded retrograde transvenous obliteration using a microballoon catheter for intractable gastric fundal varices. AU - Imai,Yukinori, AU - Nakazawa,Manabu, AU - Ando,Satsuki, AU - Sugawara,Kayoko, AU - Hamaoka,Kazuhiro, AU - Oka,Masashi, AU - Mochida,Satoshi, PY - 2013/07/09/accepted PY - 2013/8/10/entrez PY - 2013/8/10/pubmed PY - 2014/9/30/medline KW - B-RTO KW - left inferior phrenic vein KW - microballoon catheter KW - pericardiophrenic vein SP - 365 EP - 71 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 29 IS - 2 N2 - BACKGROUND AND AIM: Balloon-occluded retrograde transvenous obliteration (B-RTO) is recognized as the standard therapy for patients with gastric fundal varices in Japan; however, the procedure is difficult when drainage veins other than the gastrorenal shunt developed. The efficacy and safety of B-RTO using a microballoon catheter for such patients were evaluated. METHODS: The subjects were 99 patients with gastric fundal varices who fulfilled the criteria for receiving endoscopic and/or interventional therapies. Among these, 95 patients underwent B-RTO. Of the 95 patients, 14 were treated with the use of microballoon catheters, including nine in whom the left inferior phrenic vein was found as a secondary drainage vein in addition to the gastrorenal shunt, and five in whom a gastrorenal shunt was absent. The B-RTO procedure performed using a microballoon catheter inserted through the left inferior phrenic vein in 13 patients, and through the pericardiophrenic vein in one patient. RESULTS: The B-RTO procedure using microballoon catheters was successful in 13 of the 14 patients (93%), while in the remaining one patient, multiple drainage veins were visualized on venography. Complete obliteration of the varices was achieved in all the 13 patients by injection of 5% ethanolamine oleate iopamidol at a median volume of 25 mL (range, 11 to 40 mL) through the catheters. None of the patients showed injuries of the drainage veins or any systemic complications. CONCLUSIONS: B-RTO using a microballoon catheter is useful for the treatment of gastric fundal varices in which drainage veins other than the gastrorenal shunt developed. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/23927078/Balloon_occluded_retrograde_transvenous_obliteration_using_a_microballoon_catheter_for_intractable_gastric_fundal_varices_ L2 - https://doi.org/10.1111/jgh.12351 DB - PRIME DP - Unbound Medicine ER -