Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

Ono, Yasuyuki; Kariya, Shuji; Nakatani, Miyuki; Yoshida, Rie; Kono, Yumiko; Naoki, Katsuhiko; Ueno, Yoshio; Komemushi, Atsushi; Tanigawa, Noboru

doi:10.1007/s00270-015-1174-4

Cited by 9 publications

(9 citation statements)

References 10 publications

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“…Direct percutaneous access to the portal venous system is not widely known, and a small number of case series and case reports have reported the usefulness of direct access to the portal venous system [7] , [8] , [9] , [10] , [11] . When direct access is performed, hemostasis at the puncture site becomes the problem.…”

Section: Discussionmentioning

confidence: 99%

Direct percutaneous access to an omental vein for embolization of Roux-en-Y limb varices in a child

Onishi

Shimizu

Ogawa

et al. 2022

Radiology Case Reports

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An 11-year-old boy with a history of hepatoblastoma treated with chemotherapy, radiation therapy, and liver transplantation presented with bleeding from Roux-en-Y limb varices. The transhepatic approach for portal intervention posed a risk of liver graft injury. An omental vein that was dilated as a collateral vein due to portal hypertension was found and compressible under ultrasound. The omental vein was percutaneously punctured, and the varices were embolized through a jejunal vein. No complication occurred. Direct percutaneous access to the portal venous system is a useful technique for portal embolization.

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Section: Discussionmentioning

confidence: 99%

Direct percutaneous access to an omental vein for embolization of Roux-en-Y limb varices in a child

Onishi

Shimizu

Ogawa

et al. 2022

Radiology Case Reports

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“…Direct percutaneous access to the portal venous system is another option. Few studies have described this technique [7] , [8] , [9] , [10] . Two studies have reported direct percutaneous access to the superior rectal vein for antegrade embolization of rectal varices [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have described this technique [7] , [8] , [9] , [10] . Two studies have reported direct percutaneous access to the superior rectal vein for antegrade embolization of rectal varices [ 7 , 8 ]. After embolization, N-butyl cyanoacrylate mixed with lipiodol was infused to prevent bleeding from the access site.…”

Section: Discussionmentioning

confidence: 99%

Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report

Onishi¹,

Shimizu²,

Tsunoda³

et al. 2021

Radiology Case Reports

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A 79-year-old woman with a history of advanced gastric cancer and portal vein tumor thrombus, treated with surgery and chemoradiotherapy, presented with hematemesis due to esophageal variceal bleeding around the esophagojejunal anastomosis. Endoscopic treatment was unsuccessful. Due to portal vein occlusion, percutaneous transhepatic access was difficult. Thus, the middle colic vein, which was dilated due to portal vein occlusion, was percutaneously punctured, and antegrade embolization of a jejunal vein feeding the varices was performed using a microcatheter through a 4-F dilator placed as a sheath. After embolization, the sheath was removed, and ultrasound-guided compression of the puncture site was performed. No bleeding complication occurred. Therefore, direct percutaneous access to a mesenteric vein is a viable alternative to transhepatic access.

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“…Table 1 shows reported interventional approaches to management of rectal variceal bleeds in portal hypertension. [4][5][6][7][8][9][10] Endoscopic sclerotherapy and banding based occlusion of blood supply or main drainage routes is difficult, requiring multiple sessions for variceal eradication and TIPSS is effective in only select group of patients. The BRTO, is ineffective and difficult to perform when multiple drainage routes are involved and complete shunt tributary flow cannot be stopped with additional waiting time for sclerosant to obliterate the shunt.…”

Section: Discussionmentioning

confidence: 99%

First Report of Balloon-Occluded Antegrade Cyanoacrylate Glue Embolization (BAGE) for Bleeding Rectal Varices from India

Kumar¹,

Philips²,

Augustine³

2018

OGH Reports

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Rectal variceal bleeding occurs in 38% of patients with portal hypertension leading to an overall mortality in 5%. Conventional management involves endoscopic measures utilizing sclerotherapy/glue injection/banding ligation or surgical management. Some patients, mostly Child A or B cirrhotics, pose difficulty for traditional management and have been shown to benefit from transjugular intrahepatic portosystemic shunting (TIPSS) or interventional balloon occluded shunt embolization procedures, balloon occluded transvenous obliteration being the most common used modality, however, seldom reported in literature. In this report, we present the case, through striking images and real time step by step procedural video; of a difficult to control rectal variceal bleeding in a Child C cirrhotic in whom, balloon occluded antegrade glue embolization of multiple shunts was performed with beneficial outcomes.

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Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

Cited by 9 publications

References 10 publications

Direct percutaneous access to an omental vein for embolization of Roux-en-Y limb varices in a child

Direct percutaneous access to an omental vein for embolization of Roux-en-Y limb varices in a child

Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report

First Report of Balloon-Occluded Antegrade Cyanoacrylate Glue Embolization (BAGE) for Bleeding Rectal Varices from India

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