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Balloon-occluded retrograde transvenous obliteration for treatment of gastric varices

Journal

WORLD JOURNAL OF HEPATOLOGY
Volume 13, Issue 6, Pages 650-661

Publisher

BAISHIDENG PUBLISHING GROUP INC
DOI: 10.4254/wjh.v13.i6.650

Keywords

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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BRTO is an effective treatment for GVs, and simplifying the blood flow route from GVs to the gastrorenal shunt is crucial for success. Combining BRTO with partial splenic embolization may prevent worsening of esophageal varices and shows promise as a treatment option.
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.

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