plug assisted retrograde transvenous obliteration

Conclusion: BORTO is a safe and effective treatment for gastric varices. Neither a recurrence nor an aggravation of gastric varices were found. Results: The gastric varices completely disappeared in 12 of 14 patients and was partially resolved in the remaining 2 patients. Patients were followed up with endoscopy and enhanced CT at 1 week, 1, 3, and 6 months after the procedure and every more » 6 months thereafter. The balloon was inflated, and 5% ethanolamine oleate iopamidol was infused slowly through the catheter. A 6 Fr Simmons-shaped balloon catheter was inserted into the gastrorenal shunt. The gastric varices were confirmed by endoscopy, and their feeding and draining veins were identified by contrast-enhanced computed tomography (CT) and angiography. Methods: BORTO was performed in 14 patients with gastric varices due to liver cirrhosis. Purpose: To evaluate the clinical feasibility of balloon-occluded retrograde transvenous obliteration (BORTO) for gastric varices. Gastric varices can be treated more simply by using this catheter system. B-RTO using the new coaxial balloon catheter is feasible. No procedure-related complications were observed. The remaining case required re-treatment that resulted in complete obstruction of the varices after the second B-RTO. Complete obliteration of gastric varices on initial follow-up CT was obtained in 7 cases. Coil embolization of the collateral draining vein was required in 2 cases. The amount of injected EOI ranged from 3 to 34 ml. The balloon catheter could be advanced into the proximal potion of the gastrorenal shunt beyond the collateral draining vein in all cases. The occlusion rate was assessed by postcontrast CT within 2 weeks after B-RTO. The procedures, including maneuverability of the catheter, amount of injected sclerosing agent, necessity for coil embolization of collateral draining veins, and initial clinical results, were evaluated retrospectively. Five percent ethanolamine oleate iopamidol (EOI) was used as sclerosing agent. Between July 2003 and April 2005, 8 consecutive patients (6 men, 2 women age range 33-72 years, mean age more » 55.5 years) underwent B-RTO using the balloon catheter system.

The catheter balloons are made of natural rubber and can be inflated to 2 cm (guiding) and 1 cm (5 Fr) maximum diameter. A 5 Fr catheter has a high flexibility and can be coaxially inserted into the guiding catheter in advance. A coaxial balloon catheter system was constructed with 9 Fr guiding balloon catheter and 5 Fr balloon catheter. To develop a new coaxial balloon catheter system and evaluate its clinical feasibility for balloon-occluded retrograde transvenous obliteration (B-RTO).

Plug assisted retrograde transvenous obliteration