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balloon-occluded retrograde transvenous obliteration with lauromacrogol sclerosant foam for gastric varices

Journal of Interventional Medicine 2022年第3期5卷 138-142页

作者： Zhiyang Wu Wei Wu Cheng Tao Qin Liu Wenchang Li Qinbing Wang Wei Huang Junwei Gu Xiaoyan Fei Zhongmin Wang Xiaoyi Ding Department of Interventional Radiology Rujin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China Department of Gastroenterology Rujin HospitalShanghai Jiao Tong Universiy School of MedicineShanghai200025China Department of Radiology University of Pttsburgh School of MedicinePittsburgh15213PennsylvaniaUSA Shanghai Clinical Research Center Member for Interventional Medicine China

Objectives:To evaluate the safety and efficacy of balloon-occluded retrograde transvenous obliteration(BRTO)using lauromacrogol sclerosant foam for gastric varices(GVs)with gastrorenal venous ***:Data of GV patients treated with BRTO using lauromacrogol sclerosant foam in 2016–2020 were retrospectively analyzed along with procedural success rate,complications,and follow-up ***:A total of 31 patients were treated with *** sclerosant foam was prepared by mixing iodinated oil,lauromacrogol,and air at a 1:2:3 *** BRTO procedure was successfully completed in 93.5%of *** patient was allergic to the lauromacrogol injection.A mild postoperative fever occurred in three *** patient experienced grand mal seizures after the *** was no significant difference in the median Child-Turcotte-Pugh scores before versus after *** GV resolution was observed in 93.1%of *** patient underwent endoscopic treatment for the development of high-risk esophageal *** patient underwent transjugular intrahepatic portosystemic shunt placement for the aggravation of ***:Lauromacrogol sclerosant foam is safe and effective in patients undergoing BRTO for GV.

关键词： Gastric varices Gastrorenal shunt balloon-occluded retrograde transvenous obliteration Sclerotherapy

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balloon-occluded retrograde transvenous obliteration for treatment of gastric varices

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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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Treatment of portosystemic shunt-borne hepatic encephalopathy in a 97-year-old woman using balloon-occluded retrograde transvenous obliteration:A case report

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World Journal of Clinical Cases 2023年第4期11卷 945-951页

作者： Akihiro Nishi Tsuneaki Kenzaka Misa Sogi Shuichiro Nakaminato Takahiro Suzuki General Medicine Awa Regional Medical CenterTateyama 2940014ChibaJapan Division of Community Medicine and Career Development Kobe University Graduate School of MedicineKobe 6500017HyogoJapan Department of Radiology Kameda Medical CenterKamogawa 2968602ChibaJapan

BACKGROUND Hyperammonemia and hepatic encephalopathy are common in patients with portosystemic *** shunt occlusion has been standard treatment,although recently the less invasive balloon-occluded retrograde transvenous obliteration(B-RTO)has gained increasing *** far,there have been no reports on the treatment of portosystemic shunts with B-RTO in patients aged over 90 *** this study,we present a case of hepatic encephalopathy caused by shunting of the left common iliac and inferior mesenteric veins,successfully treated with *** SUMMARY A 97-year-old woman with no history of liver disease was admitted to our hospital because of disturbance of *** had no jaundice,spider angioma,palmar erythema,hepatosplenomegaly,or *** blood tests showed hyperammonemia,and abdominal contrast-enhanced computed tomography revealed a portosystemic shunt running between the left common iliac vein and the inferior mesenteric *** was diagnosed with hepatic encephalopathy secondary to a portosystemic *** patient did not improve with conservative treatment:Lactulose,rifaximin,and a low-protein diet.B-RTO was performed,which resulted in shunt closure and improvement in hyperammonemia and disturbance of ***,there was no abdominal pain or elevated levels of liver enzymes due to *** patient was discharged without further consciousness *** Portosystemic shunt-borne hepatic encephalopathy must be considered in the differential diagnosis for consciousness disturbance,including abnormal behavior and speech.

关键词： Hepatic encephalopathy Hyperammonemia Portosystemic shunt balloon-occluded retrograde transvenous obliteration Elderly Case report

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Ectopic Ascending Colonic Variceal Bleeding Treated with balloon-occluded retrograde transvenous obliteration in a Decompensated Liver Cirrhosis Patient—A Hepatology Perspective

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Case Reports in Clinical Medicine 2020年第7期9卷 191-200页

作者： Gim Hin Ho Suresh Babu Chern Hao Chong Constantinos P. Anastassiades Division of Gastroenterology Department of Medicine Khoo Teck Puat Hospital Singapore Department of Diagnostic Radiology Interventional Radiology Khoo Teck Puat Hospital Singapore Gut Care Digestive Liver Endoscopy Associates Singapore Division of Gastroenterology and Hepatology Department of Medicine National University Hospital Singapore

Ectopic colonic varices development from liver cirrhosis and portal hypertension is uncommon. They are part of the spectrum of portal hypertensive colopathy. Colonic variceal bleeding remains a rare cause of lower gastrointestinal tract (GI) bleeding. Due to the paucity of cases, there are no well-established conventional treatments for bleeding colonic varices. Different treatments have been reported. Here, we report a case of a 55-year-old gentleman, with a history of alcoholic liver cirrhosis, presenting with severe lower GI bleeding and symptomatic anaemia. An esophagogastroduodenoscopy revealed large esophageal varices with high-risk bleeding stigmata requiring endoscopic variceal ligation. A cross-sectional computed tomography scan showed colonic portosystemic shunts. In light of this and that the severe lower GI bleeding seemed out of proportion to the esophageal varices seen on upper endoscopy, an urgent unprepped colonoscopy was performed which revealed possible bleeding diverticula disease which required endoscopic mechanical hemoclip therapy. However, despite this, patient had recurrence of lower GI bleeding prompting a second colonoscopy. This relook colonoscopy showed ectopic ascending colon varices with high-risk bleeding stigmata. High-dose intravenous vasoactive agent somatostatin (500 mcg/hour) and subsequently terlipressin (2 mg every 4 hours) were used. The patient subsequently underwent successful balloon-occluded retrograde transvenous obliteration (B-RTO) and sclerotherapy. The non-selective beta-blocker (NSBB) carvedilol was started and bridged together with the vasoactive agent until stabilisation of portal hypertension. This difficult case illustrates the dynamic nature of portal hypertensive bleeding. It also highlights the presence of confounding non-variceal pathology complicating diagnosis of portal hypertensive colonic variceal bleeding, and that ectopic ascending colonic variceal bleeding can be treated successfully with B-RTO and scle

关键词： Ectopic Varices Colonic Varices Portal Hypertension balloon-occluded retrograde transvenous obliteration Sclerotherapy Liver Cirrhosis

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