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

Zhiyang Wu; Wei Wu; Cheng Tao; Qin Liu; Wenchang Li; Qinbing Wang; Wei Huang; Junwei Gu; Xiaoyan Fei; Zhongmin Wang; Xiaoyi Ding

doi:10.1016/j.jimed.2022.06.002

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

J Interv Med. 2022 Jun 16;5(3):138-142. doi: 10.1016/j.jimed.2022.06.002. eCollection 2022 Aug.

Authors

Zhiyang Wu^{1

2}, Wei Wu³, Cheng Tao⁴, Qin Liu^{1

2}, Wenchang Li^{1

2}, Qinbing Wang^{1

2}, Wei Huang^{1

2}, Junwei Gu^{1

2}, Xiaoyan Fei^{1

2}, Zhongmin Wang^{1

2}, Xiaoyi Ding^{1

2}

Affiliations

¹ Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
² Shanghai Clinical Research Center Member for Interventional Medicine, China.
³ Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
⁴ Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, 15213, Pennsylvania, USA.

Abstract

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 shunts.

Methods: 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 efficacy.

Results: A total of 31 patients were treated with BRTO. The sclerosant foam was prepared by mixing iodinated oil, lauromacrogol, and air at a 1:2:3 ratio. The BRTO procedure was successfully completed in 93.5% of patients. One patient was allergic to the lauromacrogol injection. A mild postoperative fever occurred in three patients. One patient experienced grand mal seizures after the procedure. There was no significant difference in the median Child-Turcotte-Pugh scores before versus after BRTO. Complete GV resolution was observed in 93.1% of patients. One patient underwent endoscopic treatment for the development of high-risk esophageal varices. Another patient underwent transjugular intrahepatic portosystemic shunt placement for the aggravation of ascites.

Conclusions: Lauromacrogol sclerosant foam is safe and effective in patients undergoing BRTO for GV.

Keywords: Balloon-occluded retrograde transvenous obliteration; Gastric varices; Gastrorenal shunt; Sclerotherapy.