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Balloon-occluded retrograde transvenous obliteration for treatment of gastric varices

World Journal of Hepatology 2021年第6期13卷 650-661页

作者： Nobuo Waguri akihiko osaki Yusuke Watanabe Department of Gastroenterology and Hepatology Niigata City General HospitalNiigata 950-1197Japan

Rupture of gastric varices(GVs)can be ***-occluded retrograde transvenous obliteration(BRTO),as known as retrograde sclerotherapy,has been widely adopted for treatment of GVs because of its effectiveness,ability to cure,and utility in emergency and prophylactic *** the route of blood flow from GVs to the gastrorenal shunt is important for the successful *** review outlines BRTO indications and contraindications,describes basic BRTO procedures and modifications,compares BRTO with other GVs treatments,and discusses various combination *** BRTO and partial splenic embolization may prevent exacerbation of esophageal varices and shows promise as a treatment option.

关键词： Gastric varices Balloon-occluded retrograde transvenous obliteration Balloon-occluded antegrade transvenous obliteration Partial splenic embolization Transjugular intrahepatic portosystemic shunt Plug-and coil-assisted retrograde transvenous obliteration

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Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis

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World Journal of Gastroenterology 2010年第23期16卷 2918-2925页

作者： akihiko osaki Tomoyuki Kubota Takeshi Suda Masato Igarashi Keisuke Nagasaki Atsunori Tsuchiya Masahiko Yano Yasushi Tamura Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Toru Kikuchi Minoru Nomoto Yutaka Aoyagi Department of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata University Department of Homeostatic Regulation and Development Graduate School of Medical and Dental SciencesNiigata University Department of Laboratory Medicine Niigata University Medical and Dental Hospital

AIM:To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis(NASH).METHODS:In total 26 patients,23 NASHs and 3 normal controls were enrolled in this *** was staged based on Brunt *** a region of interest(ROI),a shear wave was evoked by implementing an acoustic radiation force impulse(ARFI),and the propagation velocity was quantif ***:Shear wave velocity(SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases,in which a reliable SWV value was not calculated at several *** average SWV of 1.34 ± 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 ± 0.74 m/s and 2.90 ± 1.01 m/s in stages 3 and 4,respectively,but was not significantly different from 1.79 ± 0.78 m/s in stage *** a cutoff value was set at 1.47 m/s,receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1(P=0.0092) with sensitivity,specificity and area under curve of 100%,75% and 94.2%,*** addition,the correlation between SWV and hyaluronic acid was significant(P<0.0001),while a tendency toward negative correlation was observed with serum albumin(P=0.053).CONCLUSION:The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position,which has the potential to shed new light on NASH management.

关键词： Nonalcoholic steatohepatitis Ultrasound Liver stiffness measurement Shear wave velocity Acoustic radiation force impulse

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