Comparison of Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Using Ethanolamine Oleate (EO), BRTO Using Sodium Tetradecyl Sulfate (STS) Foam and Vascular Plug-Assisted Retrograde Transvenous Obliteration (PARTO)

Kim, Young Hwan; Kim, Chan Sun; Kang, Ung Rae; Kim, See Hyung; Kim, Joo Hwan

doi:10.1007/s00270-015-1288-8

Cited by 43 publications

(55 citation statements)

References 14 publications

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“…Another advantage of PARTO and CARTO is that gelatin sponge can replace the harmful sclerosants. However, in a retrospective study, PARTO was associated with frequent recurrence of GVs (32.8%; 4/18 cases) during 1‐year follow‐up in marked contrast to BRTO with EO (3.1%; 2/34 cases) or STS foam (0%; 0/18 cases). Frequent recurrence of IGVs probably occurred because the gelatin sponge was able to embolize the GVs only temporary and did not have a sufficient effect to destruct the endothelial cell.…”

Section: Comparison Between Various Sclerosants and Balloon‐occluded mentioning

confidence: 88%

“…[18][19][20][21][22][23][24][25][26][27][28] In this process, several types of sclerosants such as EO, sodium tetradecyl sulfate (STS), 29,30 and polidocanol are used [31][32][33] (Table 1). Recently, various modified BRTO techniques had been developed, including vascular plug-assisted retrograde transvenous obliteration (PARTO) [34][35][36] and coil-assisted retrograde transvenous obliteration (CARTO) 37 ( Table 2).…”

Section: Introductionmentioning

confidence: 99%

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Recent development of balloon‐occluded retrograde transvenous obliteration

Kobayakawa

Ohnishi

Suzuki

2018

J of Gastro and Hepatol

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Gastric varices (GVs) are a major complication of portal hypertension in patients with liver cirrhosis. The mortality rate associated with the bleeding from GVs is not low. Balloon-occluded retrograde transvenous obliteration (BRTO) was first introduced by Kanagawa et al. as a treatment for isolated GVs in 1994. It has been performed most frequently in Asia, especially in Japan. Ethanolamine oleate was the original sclerosant used in the therapy. Since the late 2000s, BRTO using sodium tetradecyl sulfate foam or polidocanol foam as a sclerosant has been performed in many countries other than Japan. Then, early in the 2010s, modified BRTO techniques including vascular plug-assisted retrograde transvenous obliteration and coil-assisted retrograde transvenous obliteration were developed as an alternative treatment for GVs. This article provides a historical overview of BRTO using various sclerosants and modified BRTO techniques, such as plug-assisted retrograde transvenous obliteration and coil-assisted retrograde transvenous obliteration.

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Section: Comparison Between Various Sclerosants and Balloon‐occluded mentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Recent development of balloon‐occluded retrograde transvenous obliteration

Kobayakawa

Ohnishi

Suzuki

2018

J of Gastro and Hepatol

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“…To overcome these potential shortcomings of EO, some researchers have tried to use foam sclerosants in BRTO. However, some complications are also associated with foam sclerosants, such as pulmonary edema and partial portal vein thrombosis [45][46][47]. In our study, no sclerosing agents were required; hence, no complications associated with sclerosing agents were observed.…”

Section: Discussionmentioning

confidence: 48%

Balloon-Assisted Percutaneous Transhepatic Antegrade Embolization with 2-Octyl Cyanoacrylate for the Treatment of Isolated Gastric Varices with Large Gastrorenal Shunts

Wang

Meng

Huang

et al. 2019

BioMed Research International

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Aims. To evaluate the safety and effectiveness of percutaneous transhepatic antegrade embolization (PTAE) with 2-octyl cyanoacrylate assisted with balloon occlusion of the left renal vein or gastrorenal shunts (GRSs) for the treatment of isolated gastric varices (IGVs) with large GRSs. Methods. Thirty patients with IGVs associated with large GRSs who had underwent PTAE assisted with a balloon to block the opening of the GRS in the left renal vein were retrospectively evaluated and followed up. Clinical and laboratory data were collected to evaluate the technical success of the procedure, complications, changes in the liver function using Child-Pugh scores, worsening of the esophageal varices, the rebleeding rate, and survival. Laboratory data obtained before and after PTAE were compared (paired-sample t-test). Results. PTAE was technically successful in all 30 patients. No serious complications were observed except for one nonsymptomatic pulmonary embolism. During a mean follow-up of 30 months, rebleeding was observed in 4/30 (13.3%) patients, worsening of esophageal varices was observed in 4/30 (13.3%) patients, and newly developed or aggravated ascites were observed on CT in 3/30 (10%) patients. Significant improvement was observed in Child-Pugh scores (p=0.009) and the international normalized ratio (INR) (p=0.004) at 3 months after PTAE. The cumulative survival rates at 1, 2, 3, and 5 years were 96.3%, 96.3%, 79.9%, and 79.9%, respectively. Conclusion. Balloon-assisted PTAE with 2-octyl cyanoacrylate is technically feasible, safe, and effective for the treatment of IGV associated with a large GRS.

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“…9) However, they result in a higher recurrence rate of GV than BRTO. 10) Alternatively, we introduced the combination method of polidocanol foam for GV and NBCA glue packing to close the GRS, which remarkably shortened the procedure time, decreased the side effects of the sclerosant agent, and reduced medical costs as compared with coil or vascularplug. By choosing the brachial approach, as in this case, the patient can move immediately only with compression of the puncture site after BRTO.…”

Section: Discussionmentioning

confidence: 99%

Successful Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices Using Foam Sclerosant Followed by Glue Embolization of Gastrorenal Shunt via the Brachial Vein Approach in a Severely Obese Patient

Tsuruya

Koizumi

Sekiguchi

et al. 2019

Annals of Vascular Diseases

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Balloon-occluded retrograde transvenous obliteration is an effective treatment for gastric varices. In this report, we illustrate a consecutive treatment strategy via brachial vein approach and n-butyl cyanoacrylate (NBCA) packing of the gastrorenal shunt (GRS) after injecting sclerosing agent in a severely obese patient. The brachial vein approach reduced the burden on the patient, and the closure of the GRS using NBCA shortened the procedure time. These techniques may improve patient comfort as well as reduce medical costs and the risks of several complications.

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Comparison of Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Using Ethanolamine Oleate (EO), BRTO Using Sodium Tetradecyl Sulfate (STS) Foam and Vascular Plug-Assisted Retrograde Transvenous Obliteration (PARTO)

Abstract: BRTO using STS foam or PARTO is better than BRTO using EO for treatment of gastric varices in terms of complication or procedure time. However, PARTO showed frequent recurrence of gastric varices during the long-term follow-up rather than BRTO.

Cited by 43 publications

References 14 publications

Recent development of balloon‐occluded retrograde transvenous obliteration

Recent development of balloon‐occluded retrograde transvenous obliteration

Balloon-Assisted Percutaneous Transhepatic Antegrade Embolization with 2-Octyl Cyanoacrylate for the Treatment of Isolated Gastric Varices with Large Gastrorenal Shunts

Successful Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices Using Foam Sclerosant Followed by Glue Embolization of Gastrorenal Shunt via the Brachial Vein Approach in a Severely Obese Patient

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