Balloon-occluded retrograde transvenous obliteration of varices: focusing on the portal hemodynamics and the recent techniques.

Abstract:

PURPOSE:To evaluate the recent topics of Ballloon-occluded retrograde trasnvenous obliteration(B-RTO). METHOD:We overviewed the recent scientific papers regarding B-RTO. RESULT:B-RTO is a treatment method for occluding varices retrogradely using a sclerosing agent under balloon occlusion of a major draining vein. It has been recognized as an effective treatment method for gastric varices. Hepatic function reserve is improved and liver volume is increased after B-RTO. In recent years, various technical options, such as plug-assisted retrograde transvenous obliteration, coil-assisted retrograde transvenous obliteration, or foam B-RTO, have also been reported. In performing B-RTO, portal hemodynamics must be thoroughly examined radiologically. Judging the classification of the grade of collateral venous hemodynamics is important to select the appropriate embolization technique of B-RTO and to successfully occlude varices. Finally, the word "portosystemic shunt syndrome" has been proposed and the condition should be considered while selecting a treatment for gastric varices. CONCLUSION:B-RTO is effective for gastrointestinal varices and portosystemic shunts.

journal_name

Hepatol Int

journal_title

Hepatology international

authors

Hirota S,Kobayashi K,Kako Y,Takaki H,Yamakado K

doi

10.1007/s12072-017-9813-2

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

102-111

issue

Suppl 1

eissn

1936-0533

issn

1936-0541

pii

10.1007/s12072-017-9813-2

journal_volume

12

pub_type

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