Vascular plug-assisted retrograde transvenous obliteration for the treatment of gastric varices and hepatic encephalopathy

2014 ◽  
Vol 25 (3) ◽  
pp. S79-S80
Author(s):  
D. Gwon ◽  
G. Ko ◽  
J. Kim ◽  
K. Kim ◽  
E. Jung ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastric Varices ◽  
Vascular Plug

Gastric Varices and Hepatic Encephalopathy: Treatment with Vascular Plug and Gelatin Sponge–assisted Retrograde Transvenous Obliteration—A Primary Report

Radiology ◽  
2013 ◽  
Vol 268 (1) ◽  
pp. 281-287 ◽  
Author(s):  
Dong Il Gwon ◽  
Gi-Young Ko ◽  
Hyun-Ki Yoon ◽  
Kyu-Bo Sung ◽  
Jin Hyoung Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastric Varices ◽  
Gelatin Sponge ◽  
Vascular Plug

scholarly journals Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study

2021 ◽  
Author(s):  
Pushpinder S. Khera ◽  
Pawan K. Garg ◽  
Sarbesh Tiwari ◽  
Narendra Bhargava ◽  
Taruna Yadav ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Success ◽  
Gastric Varices ◽  
Early Recurrence ◽  
Single Institution ◽  
Vascular Plug ◽  
Acute Bleeding ◽  
Sclerosing Agents ◽  
Age Range ◽  
Refractory Hepatic Encephalopathy

Abstract Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol. Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied. Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications. Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate.

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

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Zi Wen Wang ◽  
Jin Chao Liu ◽  
Fang Zhao ◽  
Wen Guang Zhang ◽  
Xu Hua Duan ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Cohort Studies ◽  
Success Rate ◽  
Meta Analysis ◽  
Gastric Varices ◽  
Cochrane Library ◽  
Technical Success ◽  
Technical Success Rate ◽  
Significant Difference ◽  
Rebleeding Rate

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.

Medical Management of Portal Hypertension and Its Complications

2017 ◽  
Vol 01 (04) ◽  
pp. 235-240
Author(s):  
Tavankit Singh ◽  
Arthur McCullough
Keyword(s):  
Liver Transplantation ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Pressure Gradient ◽  
Medical Management ◽  
Hepatorenal Syndrome ◽  
Venous Pressure ◽  
Gastric Varices ◽  
Hepatic Venous Pressure Gradient

AbstractPortal hypertension, most commonly caused by cirrhosis, is defined as an elevated hepatic venous pressure gradient that can lead to complications including ascites, hepatic, esophageal/gastric varices, hepatic encephalopathy, and hepatorenal syndrome. While these complications are initially managed by medical and endoscopic treatments, progressive decompensation of liver disease may lead to liver transplantation.

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