Is salvage Plug-Assisted Retrograde Transvenous Obliteration (PARTO) safe and effective for bleeding gastric varices ?- A preliminary single-center experience

Patel, Ranjan Kumar; Tripathy, Taraprasad; Panigrahi, Manas Kumar; Nayak, Hemant Kumar; Samal, Subash Chandra; Pattnaik, Bramhadatta; Dutta, Tanmay; Gupta, Sunita; Mohakud, Sudipta; Naik, Suprava; Deep, Nerbadyeswari

doi:10.1007/s10140-024-02232-2

Emerg Radiol

2024

DOI: 10.1007/s10140-024-02232-2

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Is salvage Plug-Assisted Retrograde Transvenous Obliteration (PARTO) safe and effective for bleeding gastric varices ?- A preliminary single-center experience

Ranjan Kumar Patel,

Taraprasad Tripathy,

Manas Kumar Panigrahi

et al.

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Interventional Management of Variceal Bleeding: Techniques and Emerging Concepts

Patel,

Tripathy,

Mukund

et al. 2024

Digestive Disease Interventions

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Despite technical advancements and disease understanding, variceal bleeding remains the leading cause of mortality in patients with cirrhosis. Endoscopic therapies are the main cornerstone of therapy in variceal bleeding. Interventional radiology (IR) plays a significant role in managing variceal bleeding, especially in cases where endoscopic therapies are not feasible or failed. Cross-sectional imaging is often critical to identify relevant anatomy before IR therapies. Transjugular intrahepatic portosystemic shunt (TIPS) is indicated as salvage therapy in patients with refractory variceal bleeding. Retrograde transvenous variceal embolization (RTO) procedures provide superior bleeding control in patients with gastric and ectopic varices, however, without increasing the risk of hepatic encephalopathy and liver function deterioration. Antegrade transvenous obliteration is a viable alternative when RTO is not feasible. Left-sided portal hypertension is a distinct entity resulting from splenic vein stenosis or occlusion, and variceal bleeding in left-sided portal hypertension does not respond to TIPS, requiring variceal embolization, partial splenic embolization, or splenic vein recanalization. Occasionally, endovascular splenorenal or mesorenal shunt and splenic vein occlusion with distal splenorenal diversion are performed to control variceal bleeding. This article entails the basic concepts and procedural aspects of various interventional radiological procedures performed in patients with variceal bleeding.

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Interventional Management of Variceal Bleeding: Techniques and Emerging Concepts

Patel,

Tripathy,

Mukund

et al. 2024

Digestive Disease Interventions

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show abstract

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Is salvage Plug-Assisted Retrograde Transvenous Obliteration (PARTO) safe and effective for bleeding gastric varices ?- A preliminary single-center experience

Cited by 1 publication

References 19 publications

Interventional Management of Variceal Bleeding: Techniques and Emerging Concepts

Interventional Management of Variceal Bleeding: Techniques and Emerging Concepts

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