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Hepatology International

Erschienen in:

05.09.2017 | Special Issue - Portal Hypertension

Balloon-occluded retrograde transvenous obliteration of varices: focusing on the portal hemodynamics and the recent techniques

verfasst von: Shozo Hirota, Kaoru Kobayashi, Yasukazu Kako, Haruyuki Takaki, Koichiro Yamakado

Erschienen in: Hepatology International | Sonderheft 1/2018

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Abstract

Purpose

To evaluate the recent topics of Ballloon-occluded retrograde trasnvenous obliteration(B-RTO).

Method

We overviewed the recent scientific papers regarding B-RTO.

Result

B-RTO is a treatment method for occluding varices retrogradely using a sclerosing agent under balloon occlusion of a major draining vein. It has been recognized as an effective treatment method for gastric varices. Hepatic function reserve is improved and liver volume is increased after B-RTO. In recent years, various technical options, such as plug-assisted retrograde transvenous obliteration, coil-assisted retrograde transvenous obliteration, or foam B-RTO, have also been reported. In performing B-RTO, portal hemodynamics must be thoroughly examined radiologically. Judging the classification of the grade of collateral venous hemodynamics is important to select the appropriate embolization technique of B-RTO and to successfully occlude varices. Finally, the word “portosystemic shunt syndrome” has been proposed and the condition should be considered while selecting a treatment for gastric varices.

Conclusion

B-RTO is effective for gastrointestinal varices and portosystemic shunts.

Rosch J, Hanafee WN, Snow H. Transjugular Portal venography and radiologic portocaval shunt; an experimental study. Radiology 1969;92:1112–1114

Sauer P, Theilmann L, Stremmel W, Benz C, Richter GM, Stiehl A. Transjugular intrahepatic portosystemic stent shunt versus sclerotherapy plus propranolol for variceal rebleeding. Gastroenterology 1997;1135:1623–1631

Haska ZJ. Improved patency of transjugular intrahepatic portosystemic shunts in humans: creation and revision with PTFE stent-grafts. Radiology 1999;213:759–766

Kanagawa H, Mima S, Kouyama H, et al. Treatment of gastric fundal varices by baloon-occluded retrograde transvenous obliteration. J Gastroenterol Hepatol 1996;11:51–58

Hirota S, Matsumoto S, Tomita M, et al. Retrograde transvenous obliteration of gastric varices. Radiology 1999;211:349–356

Fukuda T, Hirota S, Sugimura K. Long-term results of balloon-occluded retrograde transvenous obliteration for the treatment of gastric varices and hepatic encephlopathy. J Vasc Interv Radiol 2001;12:327–336

Hirota S, Ichikawa S, Matsumoto S, et al. Interventional radilogic treatment for idiopathic portal hypertension. Cardiovasc Interv Radiol 1999;22:311–314

Fukuda T, Hirota S, Sugimoto K, Matsumoto S, Zamora CA, Sugimura K. “Downgrading” of gastric varices with multiple collateral veins in balloon-occluded retrograde transvenous obliteration. J Vasc Interv Radiol 2005;16(10):1379–1383

Fukuda T, Hirota S, Matsumoto S, Sugimoto K, Fujii M, Tsurusaki M, Izaki K, Sugimura K. Application of balloon-occluded retrograde transvenous obliteration to gastric varices complicating refractory ascites. Cardiovasc Interv Radiol 2004;27:64–67

10.

Hirota S, Kobayshi K, Maeda H, Yamamoto S, Nakao N. Balloon-occluded retrograde transvenous obliteration for portal hypertension. Radiat Med 2006,24:315–320

11.

Lunderquist A, Borjesson B, Owman T, Bengmark S. Isobutyl-2-cyanoacrylate(bucrylate) in obliteration of gastric coronary vein and esophageal varices. AJR 1978;130:1–6

12.

Nakao N, Sugiki K, Chin K, Miura K, Kyo A, Okamato E, Ishikawa Y, Uchida H. Transhepatic embolization of gastroesophageal varices in liver cirrhosis. Nippon Igaku Hoshasen Gakkai Zasshi 1978;38:852–861

13.

Spigos DG, Tan WS, Mozes MF, Capek V. Partial splenic embolization in the treatment of hypersplenism. AJR 1979;132:777–782

14.

Mukund A, Rajesh S, Arora A, Patidar Y, Jain D, Sarin SK. Efficacy of balloon-occluded retrograde transvenous obliteration large spontaneous ileorenal shunt in patients with severe recurrent hepatic encephalopathy with foam sclerotherapy: Initial experience. J Vasc Interv Radiol 2012;23(9):1200–1206

15.

Saad WE. Vascular anatomy and the morophologic and hemodynamic classifications of gastric varices and spontaneous portosystemic shunts relevant to the B-RTO procedure. Tech Vasc Interv Radiol 2013;16(2):60–100

16.

Saad WE. Endovascular management of gastric varices. Clin Liver Dis 2014;18:829–851

17.

Kumamoto M, Toyonaga A, Inoue H, et al. Long-term results of balloon-occluded retrograde transvenous obliteration for gastric fundal varices: Hepatic deterioration links to portosystemic shunt syndrome. Gastroenterol Hepatol 2010;25:1129–1135

18.

Inoue H, Emori K, Toyonaga A, et al. Long term results of balloon-occluded retrograde transvenous obliteration for portosystemic encephalopathy in patients with liver cirrhosis and portal hypertension. Kurume Med J 2014;61:1–8

19.

Kiyosue H, Mori H, Matsumoto S, Yamada Y, Hori Y, OkinoY. Transcatheter obliteration of gastric varices. Part 1. Anatomic classification. Radiographics 2003;23(4):911–920

20.

Tsurusaki M, Sugimoto K, Matsumoto S, Izaki K, Fukuda T, Akasak Y, Fujii M, Hirota S, Sugimura K. Bleeding duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration (B-RTO) assisted by CT during arterial portography. Cardiovasc Interv Radiol 2006;29(6):1148–1151

21.

Zamora CA, Sugimoto K, Tsurusaki M, Izaki K, Fukuda T, Matsumoto S, Kuwata Y, Kawasaki R, Taniguchi T, Hirota S, Sugimura K. Endovascular obliteration of bleeding duodenal varices in patients with liver cirrhosis. Eur Radiol 2006;16(1):73–79

22.

Masaki M, Obara K, Suzuki S, et al. The destructive effects of sclerosant ethanolamine oleate on mammalian vessel endothelium. Gastroenterol Jpn 1990;25:230–235

23.

Miyoshi H, Oshiba S, Matsumoto A, Takada K, Umegaki E, Hirata I. Haptoglobin prevents renal dysfunction associated with intravariceal infusion of ethanolamine oleate. Am J Gastroenterol 1991;86:1638–1641

24.

Nishida N, Ninoi T, Kitayama T, et al. Dual balloon-occluded retrograde transvenous obliteration of gastric varix draining into the left adrenal vein and left inferior phrenic vein. Cardiovasc Interv Radiol 2004;27:560–562

25.

Morita Y, Yamada M, Miyata M, Kubo K. Diagnostic imaging and embolotherapy for the superior mesenteric vein-inferior vena cava shunt. Nihon Igaku Hoshasen Gakkai Zasshi 1994;54(9):835–845 (25)

26.

Gaba RC. Retrograde-antergrade accelerated trap obliteration: a modified approach to transvenous eradication of gastric varices. J Vasc Interv Radiol 2017;28:291–294

27.

Gwon DI, Ko GY, Yoon HK, Sung KB, Kim JH, Shin JH, Ko HK, Song HY. Gastric varices and hepatic encephalopathy: treatment with vascular plug and gelatin sponge-assisted retrograde transvenous obliteration—a primary report. Radiology 2013;268(1):281–287

28.

Kim YH, Kim YH, Kim CS, Kang UR, Kim SH, Kim JH. Comparison of balloon-occluded retrograde transvenous obliteration (B-RTO) using ethanolamine oleate (EO), B-RTO using sodium tetradecyl sulfate (STS) foam and vascular plug-assisted retrograde transvenous obliteration (PARTO). Cardiovasc Interv Radiol 2016;39(6):840–846

29.

Lee EW, Saab S, Gomes AS, Busuttil R, McWilliams J, Durazo F, Han SH, Goldstein L, Tafti BA, Moriarty J, Loh CT, Kee ST. Coil-assisted retrograde transvenous obliteration (CARTO) for the treatment of portal hypertensive variceal bleeding: preliminary results. Clin Transl Gastroenterol 2014;5:e61

30.

JK Park, Saab S, Kee ST et al. Balloon-occluded retrograde transvenous obliteration (B-RTO) for treatment of gastric varices: review and meta-analysis. Dig Dis Sci 2015;60:1543–1553

31.

Kobayashi K, Hirota S, Kako Y, Yamamoto S, Takaki H, Yamakado K. Changes in liver stiffness on real-time tissue elastography before and after occlusion of spontaneous portosystemic shunts. Diagn Interv Imaging. 2016. doi:10.1016/j.diii.2016.08.011

32.

Lee JY, Moon SH, Lee SM, et al. A case of noncardiogenic pulmonary edema by ethanolamine oleate. Korean J Intern Med 1994;9:125–127

33.

Uchibori S. Pulmonary circulatory disturbance following endoscopic injection sclerotherapy. Nippon Kyobu Shikkan Gakkai Zasshi 1993;31:833–839

34.

Rajagopalan N, Hoffstein V. Hemothorax following uncomplicated sclerotherapy for esophageal varices. Chest 1994;106:314–315

35.

Bellary SV, Isaacs P. Disseminated intravascular coagulation (DIC) after endoscopic injection sclerotherapy with ethanolamine oleate (letter). Endoscopy 1990;22:151

36.

Kim SK, Lee KA, Sauk S, Korenblat K. Comparison of transjugular intrahepatic portosystemic shunt with covered stent and balloon-occluded retrograde transvenous obliteration in managing isolated gastric varices. Korean J Radiol 2017;18(2):345–354

37.

Lee SJ, Kim SU, Kim MD, Kim YH, Kim GM, Park SI, Won JY, Lee DY, Lee KH. Comparison of treatment outcomes between balloon-occluded retrograde transvenous obliteration and transjugular intrahepatic portosystemic shunt for gastric variceal bleeding hemostasis. J Gastroenterol Hepatol 2017. doi:10.1111/jgh.13729 (Epub ahead of print)

38.

Wang YB, Zhang JY, Gong JP, Zhang F, Zhao Y. Balloon-occluded retrograde transvenous obliteration versus transjugular intrahepatic portosystemic shunt for treatment of gastric varices due to portal hypertension: a meta-analysis. J Gastroenterol Hepatol 2016;31(4):727–733

39.

Saad WE, Kitanosono T, Koizumi J, Hirota S. The conventional balloon-occluded retrograde transvenous obliteration procedure: Indications, contraindications, and technical applications. Tech Vasc Interv Radiol. 2013;16(2):101–151

Titel: Balloon-occluded retrograde transvenous obliteration of varices: focusing on the portal hemodynamics and the recent techniques
verfasst von: Shozo Hirota
Kaoru Kobayashi
Yasukazu Kako
Haruyuki Takaki
Koichiro Yamakado
Publikationsdatum: 05.09.2017
Verlag: Springer India
Erschienen in: Hepatology International / Ausgabe Sonderheft 1/2018
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI: https://doi.org/10.1007/s12072-017-9813-2

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Balloon-occluded retrograde transvenous obliteration of varices: focusing on the portal hemodynamics and the recent techniques

Abstract

Purpose

Method

Result

Conclusion

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