Outcomes from balloon-occluded retrograde transvenous obliteration (BRTO) versus transjugular intrahepatic portosystemic shunt (TIPS) in the management of isolated gastric varices: a retrospective study in single US medical center

Sauk, Steven; Niemeyer, Matthew M.; Kim, Seonyoung; Korenblat, Kevin

doi:10.1016/j.jvir.2013.12.227

Cited by 5 publications

(14 citation statements)

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“…Only six studies were obtained for reading the full text, and finally, one study was excluded. In the end, one RCT 17 and four cohort studies [18][19][20][21] were recruited into our study. The detailed process of selection was shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Meta-analysis of five studies [17][18][19][20][21] revealed that the incidence rate of hepatic encephalopathy in the BRTO group (1.43%) was lower than that in the TIPS group (29.79%). This difference had a statistical significance (OR, 0.05; 95% CI, 0.02-0.13; P < 0.00001; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…For the postoperative renewal ascites, the difference had no statistical significance. 21 As we all know, these conclusions all came from individual study. More studies, including large sample size, were necessary to certificate the effect of BRTO and to explain the exact mechanisms.…”

Section: Discussionmentioning

confidence: 97%

“…17 One study thought that the condition that previous ascites aggravated was more common in the BRTO group, 18 but another study considered that there was no difference between both groups. and a more common possibility of regression of the gastric varices 21 , in contrast with TIPS. For the postoperative renewal ascites, the difference had no statistical significance.…”

Section: Discussionmentioning

confidence: 99%

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Balloon‐occluded retrograde transvenous obliteration versus transjugular intrahepatic portosystemic shunt for treatment of gastric varices due to portal hypertension: A meta‐analysis

Wang

Zhang

Gong

et al. 2016

J of Gastro and Hepatol

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Balloon‐occluded retrograde transvenous obliteration versus transjugular intrahepatic portosystemic shunt for treatment of gastric varices due to portal hypertension: A meta‐analysis

Wang

Zhang

Gong

et al. 2016

J of Gastro and Hepatol

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show abstract

“…We searched databases and found a meta-analysis [23] including five studies to compare the effects of TIPS and BRTO. ree of the studies were abstracts without the full article [24][25][26], which may have caused incomplete data bias.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of TIPS versus BRTO on Bleeding Gastric Varices: A Meta-Analysis

Wang

Liu

Zhao

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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Background and Aim. Upper gastrointestinal bleeding is a threat to patients with gastric varices (GVs). Previous studies have concluded that both transjugular intrahepatic portosystemic shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) are effective treatments for patients with GV. We aimed to compare the efficiency and outcomes of these two procedures in GV patients through meta-analysis. Methods. The PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched using the keywords: GV, bleeding, TIPS, and BRTO to identify relevant randomized controlled trials and cohort studies. The overall survival (OS) rate, imminent haemostasis rate, rebleeding rate, technical success rate, procedure complication rate (hepatic encephalopathy and aggravated ascites), and Child-Pugh score were evaluated. Randomized clinical trials and cohort studies comparing TIPS and BRTO for GV due to portal hypertension were included in our meta-analysis. Two independent reviewers performed data extraction and assessed the study quality. A meta-analysis was performed to calculate risk ratios (RRs), mean differences (MDs), and 95% CIs using random effects models. Results. A total of nine studies fulfilled the inclusion criteria. There was a significant difference between TIPS and BRTO in the OS rate (RR, 0.81 (95% CI, 0.66 to 0.98); P=0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P<0.00001). TIPS had a higher incidence rate of hepatic encephalopathy (RR, 16.11 (95% CI, 7.13 to 36.37); P<0.00001). There was no significant difference between TIPS and BRTO in the immediate haemostasis rate (RR, 0.99 (95% CI, 0.89 to 1.10); P=0.84), technical success rate (RR, 1.06 (95% CI, 0.98 to 1.16); P=0.16), aggravated ascites rate (RR, 0.60 (95% CI, 0.33 to 1.09); P=0.10), or Child-Pugh change (MD, 0.22 (95% CI, −0.21 to 0.65); P=0.31). Conclusions. In this meta-analysis, BRTO brought more benefits to patients, with a higher OS rate and lower rebleeding rate. BRTO is a feasible method for GVB.

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An Algorithm for Management After Transjugular Intrahepatic Portosystemic Shunt Placement According to Clinical Manifestations

et al. 2017

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We propose an algorithm for management after transjugular intrahepatic portosystemic shunt (TIPS) placement according to clinical manifestations. For patients with an initial good clinical response, surveillance Doppler ultrasound is recommended to detect stenosis or occlusion. A TIPS revision can be performed using basic or advanced techniques to treat stenosis or occlusion. In patients with an initial poor clinical response, a TIPS venogram with pressure measurements should be performed to assess shunt patency. The creation of a parallel TIPS may also be required if the patient is symptomatic and the portal pressure remains high after TIPS revision. Additional procedures may also be necessary, such as peritoneovenous shunt (Denver shunt) placement for refractory ascites, tunneled pleural catheter for hepatic hydrothorax, and balloon-occluded retrograde transvenous obliteration procedure for gastric variceal bleeding. A TIPS reduction procedure can also be performed in patients with uncontrolled hepatic encephalopathy or hepatic failure.

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Outcomes from balloon-occluded retrograde transvenous obliteration (BRTO) versus transjugular intrahepatic portosystemic shunt (TIPS) in the management of isolated gastric varices: a retrospective study in single US medical center

Cited by 5 publications

References 0 publications

Balloon‐occluded retrograde transvenous obliteration versus transjugular intrahepatic portosystemic shunt for treatment of gastric varices due to portal hypertension: A meta‐analysis

Balloon‐occluded retrograde transvenous obliteration versus transjugular intrahepatic portosystemic shunt for treatment of gastric varices due to portal hypertension: A meta‐analysis

Comparison of the Effects of TIPS versus BRTO on Bleeding Gastric Varices: A Meta-Analysis

An Algorithm for Management After Transjugular Intrahepatic Portosystemic Shunt Placement According to Clinical Manifestations

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