Prediction for Improvement of Liver Function after Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices to Manage Portosystemic Shunt Syndrome

Yamamoto, Akira; Nishida, Norifumi; Morikawa, Hiroyasu; Jogo, Atsushi; Kageyama, Ken; Sohgawa, Etsuji; Hamamoto, Shinichi; Takeshita, Toru; Sakai, Yukimasa; Matsuoka, Toshifumi; Kawada, Norifumi; Miki, Yukio

doi:10.1016/j.jvir.2016.03.031

Cited by 19 publications

(15 citation statements)

References 30 publications

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“…This can be explained by the fact that EOI binds with albumin in the blood [20] with subsequent temporary reduction of albumin level in the early post-BRTO period [8] which may predispose to ascites exacerbation. However, this is only temporary because of the well documented improvement in albumin level within 1-6 months after BRTO [21][22][23]. So, we agree with other authors regarding that ascites exacerbation after BRTO is multifactorial and could not be totally explained or predicted by one factor [10,19].…”

Section: Discussionsupporting

confidence: 81%

Conventional versus selective balloon-occluded retrograde transvenous obliteration of gastric varices

Ahmed

Kiyosue

Mori

et al. 2020

Egypt J Radiol Nucl Med

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Background: Balloon-occluded retrograde transvenous obliteration (BRTO) is a well-established interventional radiological technique for treatment of isolated gastric varices (GV). The aim of this study is to compare outcome after different BRTO techniques, i.e., conventional, selective and superselective techniques. Fifty-nine consecutive patients underwent BRTO as a primary prophylactic treatment for GV were retrospectively categorized into group A (38 patients underwent conventional BRTO) and group B (21 patients underwent selective or superselective BRTO). Group B was sub-grouped into group B1 (11 patients underwent selective BRTO) and group B2 (10 patients underwent superselective BRTO). Results: Median volume of ethanol amine oleate iopamidol (EOI) was significantly higher in group A than in group B2 (14.8 Vs 7.4 ml, p = 0.03). Complete GV thrombosis was significantly lower in group B2 (50%) than in A (89.5%, p = 0.01) and B1 (100%, p = 0.01). GV bleeding rate after BRTO was significantly higher in group B2 than in group A (20% vs 0%, p = 0.04). GV recurrence rate was not significantly different between group A and B (p = 0.5) or between group A, B1 and B2 (p = 0.1). Cumulative ascites exacerbation rate was significantly higher in group A than B (p = 0.005), B1 (p = 0.03), and B2 (p = 0.03). Cumulative esophageal varices (Es.V) aggravation rate was significantly higher in group A than B (p = 0.001), B1 (p = 0.01), and B2 (p = 0.03). Volume of EOI was a significant risk factor for ascites exacerbation (p = 0.008) while shunt occlusion and pre-existing partial portal vein thrombosis were significant risk factors for Es.V aggravation (p = 0.01 and 0.03, respectively). Conclusion: Selective and super-selective techniques had a lower ascites exacerbation, and Es.V aggravation rates than conventional technique. However, superselective BRTO had a lower GV complete thrombosis and higher GV bleeding rates after BRTO than other techniques.

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Section: Discussionsupporting

confidence: 81%

Conventional versus selective balloon-occluded retrograde transvenous obliteration of gastric varices

Ahmed

Kiyosue

Mori

et al. 2020

Egypt J Radiol Nucl Med

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“…Yamamoto et al . demonstrated that a lower LS level determined by TE was a predictive factor of improvements in albumin level, which is indicative of hepatic synthetic function, post‐BRTO, and that the best cutoff point for the LS value was 22.9 kPa, with sensitivity and specificity of 78.4% and 69.2%, respectively, for predictions of albumin level improvements after PSS occlusion . Recently, Rajakannu et al .…”

Section: Discussionmentioning

confidence: 97%

Liver stiffness measured by transient elastography as predictor of prognoses following portosystemic shunt occlusion

Ishikawa

Sasaki

Nishimura

et al. 2018

J of Gastro and Hepatol

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“…EV and EV rupture may develop when the HVPG increases over a threshold value of 10 -12 mmHg [28,29]. Recently, LS measured by TE before B-RTO was also reported to be a significant exacerbation factor for EV after B-RTO [30]. LS meas-ured by TE is a rapid and noninvasive method for the diagnosis of portal hypertension in patients with liver cirrhosis [12,13].…”

Section: Discussionmentioning

confidence: 99%

Changes in Liver and Spleen Stiffness by Virtual Touch Quantification Technique after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices and Exacerbation of Esophageal Varices: A Preliminary Study

et al. 2019

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Purpose To assess liver stiffness (LS) and spleen stiffness (SS) values measured by virtual touch quantification (VTQ) technique in the monitoring of portal pressure and their usefulness for the prediction of the exacerbation of esophageal varices (EV) in patients with gastric varices undergoing balloon-occluded retrograde transvenous obliteration (B-RTO). Materials and Methods The LS, SS, and hepatic venous pressure gradient (HVPG) were measured in 20 patients both before and after B-RTO. The change in each parameter between the two groups (EV exacerbation and non-exacerbation groups) was compared by analysis of variance. The efficacy of the parameters for the prediction of the exacerbation of EV was analyzed using a receiver operating characteristic (ROC) curve analysis. Results 9 patients (40.9 %) exhibited an exacerbation of EV within 24 months after B-RTO. Signiﬁcant changes were observed in the HVPG and SS after B-RTO between the two groups (EV exacerbation group vs. non-exacerbation group: HVPG before 12.7 ± 4.4 mmHg vs. 11.0 ± 4.4 mmHg; HVPG after 19.6 ± 6.0 mmHg vs. 13.6 ± 3.1 mmHg P = 0.003; SS before 3.40 ± 0.50 m/s vs. 3.20 ± 0.51 m/s; SS after 3.74 ± 0.53 m/s vs. 3.34 ± 0.43 m/s P = 0.016). However, no signiﬁcant changes in LS were observed between the two groups. The area under the ROC curves of elevation in HVPG and SS for the prediction of the exacerbation of EV after B-RTO were 0.833 and 0.818, respectively. Conclusion Elevation of the HVPG and SS measured by VTQ after B-RTO was useful for the prediction of the exacerbation of EV.

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Prediction for Improvement of Liver Function after Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices to Manage Portosystemic Shunt Syndrome

Cited by 19 publications

References 30 publications

Conventional versus selective balloon-occluded retrograde transvenous obliteration of gastric varices

Conventional versus selective balloon-occluded retrograde transvenous obliteration of gastric varices

Liver stiffness measured by transient elastography as predictor of prognoses following portosystemic shunt occlusion

Changes in Liver and Spleen Stiffness by Virtual Touch Quantification Technique after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices and Exacerbation of Esophageal Varices: A Preliminary Study

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