Balloon-occluded retrograde transvenous obliteration for treatment of gastric varices

Nobuo Waguri; Akihiko Osaki; Yusuke Watanabe

doi:10.4254/wjh.v13.i6.650

Balloon-occluded retrograde transvenous obliteration for treatment of gastric varices

World J Hepatol. 2021 Jun 27;13(6):650-661. doi: 10.4254/wjh.v13.i6.650.

Authors

Nobuo Waguri¹, Akihiko Osaki², Yusuke Watanabe²

Affiliations

¹ Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata 950-1197, Japan. waguri@hosp.niigata.niigata.jp.
² Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata 950-1197, Japan.

Abstract

Rupture of gastric varices (GVs) can be fatal. Balloon-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 treatment. Simplifying the route of blood flow from GVs to the gastrorenal shunt is important for the successful BRTO. This review outlines BRTO indications and contraindications, describes basic BRTO procedures and modifications, compares BRTO with other GVs treatments, and discusses various combination therapies. Combined BRTO and partial splenic embolization may prevent exacerbation of esophageal varices and shows promise as a treatment option.

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

Publication types

Review