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Factors related to thrombosis of gastric varix during balloon-occluded retrograde transvenous obliteration.
Acta Radiol. 2015 May; 56(5):592-7.AR

Abstract

BACKGROUND

Balloon-occluded retrograde transvenous obliteration (B-RTO) has become known as an effective treatment for gastric varices with a gastrorenal shunt. However, the appropriate duration to maintain inflation of the catheter balloon for sufficient thrombosis has been unknown.

PURPOSE

To evaluate retrospectively the factors related to the development of thrombus in gastric varices by evaluating the necessity of the addition of a sclerosing agent on the second day in overnight B-RTO.

MATERIAL AND METHODS

Sixty-five patients who underwent B-RTO for gastric varices with a gastrorenal shunt were studied. The B-RTO catheter was retained overnight in all patients. Incidence of and factors influencing the necessity of additional injections of a sclerosing agent on the second day were investigated.

RESULTS

In all 65 patients (100%), B-RTO was technically successful and in 61 patients (93.8%) complete thrombosis of the gastric varices was achieved. In 46 of the 65 patients (70.8%), the sclerosing agent was added on the second day. Higher Child-Pugh score, in particular, lower serum albumin level, and higher prothrombin time-international normalized ratio (PT-INR) were significantly associated with the need for the addition of the sclerosing agent on the second day. Optimal cut-off values for the serum albumin level and PT-INR were 3.6 g/dL and 1.13, respectively.

CONCLUSION

Liver function might influence the development of thrombosis of gastric varices in B-RTO. Serum albumin and PT-INR levels would provide information for deciding on the duration of retention of the B-RTO catheter to obtain sufficient therapeutic effectiveness.

Authors+Show Affiliations

Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan rika442@hiroshima-u.ac.jp.Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.Department of Radiology, Fukuchiyama City Hospital, Kyoto, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24812417

Citation

Yoshimatsu, Rika, et al. "Factors Related to Thrombosis of Gastric Varix During Balloon-occluded Retrograde Transvenous Obliteration." Acta Radiologica (Stockholm, Sweden : 1987), vol. 56, no. 5, 2015, pp. 592-7.
Yoshimatsu R, Yamagami T, Miura H, et al. Factors related to thrombosis of gastric varix during balloon-occluded retrograde transvenous obliteration. Acta Radiol. 2015;56(5):592-7.
Yoshimatsu, R., Yamagami, T., Miura, H., & Hashiba, M. (2015). Factors related to thrombosis of gastric varix during balloon-occluded retrograde transvenous obliteration. Acta Radiologica (Stockholm, Sweden : 1987), 56(5), 592-7. https://doi.org/10.1177/0284185114532080
Yoshimatsu R, et al. Factors Related to Thrombosis of Gastric Varix During Balloon-occluded Retrograde Transvenous Obliteration. Acta Radiol. 2015;56(5):592-7. PubMed PMID: 24812417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors related to thrombosis of gastric varix during balloon-occluded retrograde transvenous obliteration. AU - Yoshimatsu,Rika, AU - Yamagami,Takuji, AU - Miura,Hiroshi, AU - Hashiba,Mitsuoki, Y1 - 2014/05/08/ PY - 2013/11/09/received PY - 2014/03/26/accepted PY - 2014/5/10/entrez PY - 2014/5/9/pubmed PY - 2015/6/16/medline KW - Balloon-occluded retrograde transvenous obliteration KW - gastric varices SP - 592 EP - 7 JF - Acta radiologica (Stockholm, Sweden : 1987) JO - Acta Radiol VL - 56 IS - 5 N2 - BACKGROUND: Balloon-occluded retrograde transvenous obliteration (B-RTO) has become known as an effective treatment for gastric varices with a gastrorenal shunt. However, the appropriate duration to maintain inflation of the catheter balloon for sufficient thrombosis has been unknown. PURPOSE: To evaluate retrospectively the factors related to the development of thrombus in gastric varices by evaluating the necessity of the addition of a sclerosing agent on the second day in overnight B-RTO. MATERIAL AND METHODS: Sixty-five patients who underwent B-RTO for gastric varices with a gastrorenal shunt were studied. The B-RTO catheter was retained overnight in all patients. Incidence of and factors influencing the necessity of additional injections of a sclerosing agent on the second day were investigated. RESULTS: In all 65 patients (100%), B-RTO was technically successful and in 61 patients (93.8%) complete thrombosis of the gastric varices was achieved. In 46 of the 65 patients (70.8%), the sclerosing agent was added on the second day. Higher Child-Pugh score, in particular, lower serum albumin level, and higher prothrombin time-international normalized ratio (PT-INR) were significantly associated with the need for the addition of the sclerosing agent on the second day. Optimal cut-off values for the serum albumin level and PT-INR were 3.6 g/dL and 1.13, respectively. CONCLUSION: Liver function might influence the development of thrombosis of gastric varices in B-RTO. Serum albumin and PT-INR levels would provide information for deciding on the duration of retention of the B-RTO catheter to obtain sufficient therapeutic effectiveness. SN - 1600-0455 UR - https://www.unboundmedicine.com/medline/citation/24812417/Factors_related_to_thrombosis_of_gastric_varix_during_balloon_occluded_retrograde_transvenous_obliteration_ L2 - https://journals.sagepub.com/doi/10.1177/0284185114532080?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -