Abstract

Safety and Efficacy of Modified BRTO-Assisted Endoscopic Histoacryl Injection for the Treatment of Isolated Gastric Varices with Gastro-Renal Shunt

Highlights

  • Esophagogastric varices are some of the most frequent complications of liver cirrhosis and portal hypertension

  • All patients completed the E-balloon-occluded retrograde transvenous obliteration (BRTO) procedure with a technical success rate of 100% (Table 1)

  • Recurrence and re-bleeding occurred in one patient, who was treated successfully by another endoscopic Histoacryl injection experienced 22 months after the procedure

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Summary

Introduction

Esophagogastric varices are some of the most frequent complications of liver cirrhosis and portal hypertension. The incidence rate of Isolated Gastric Varices (IGV) is lower than Esophageal Varices (EV). The current therapeutic options for IGV include medications, endoscopic therapy, surgery, and radiological interventions such as Transjugular Intrahepatic Portosystemic Shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) [3]. TIPS is useful for the treatment of IGV with large-diameter gastrorenal shunts (GRS). Some studies have shown that the long-term re-bleeding rate of IGV after TIPS is lower than that of tissue adhesive injection, but the incidence of hepatic encephalopathy is significantly higher [4]. Ectopic embolization is the most serious complication of gastric variceal Histoacryl injection for the treatment of Isolated Gastric Varices (IGV) with Gastro-Renal Shunt (GRS). To evaluate the safety and efficacy of modified balloon-occluded retrograde transvenous obliteration-assisted Endoscopic Histoacryl Injection (E-BRTO) for the treatment of IGV with GRS

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