Clayton W. Commander MD, PhD, Presenter: Nothing to Disclose

Hyeon Yu MD, Abstract Co-Author: Nothing to Disclose

Ari Joel Isaacson MD, Abstract Co-Author: Nothing to Disclose

Matthew A. Mauro MD, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sclerosant (balloon) dwell times of less than or equal to one hour in patients with gastric varices.

The study comprised 22 patients (12 male; 10 female; mean age 58 years; age range 21-89 years) who underwent a total of 23 BRTO procedures for treatment of bleeding gastric varices at a single institution from August 2007-November 2013. For all patients, the procedure was performed using 3% sodium tetradecyl sulfate mixed with ethiodized oil and air in a 2:1:3 ratio. The maximum dwell time of the sclerosant mixture was 60 minutes. All cases were reviewed using imaging and clinical data available in the medical record as well as by telephone interview.

The mean dwell time of the sclerosant mixture for all patients was 32.7 minutes (range 5–60 min). In 10 patients, additional embolization was performed with coils (n=9) or Amplatzer plugs (n=1), while 12 patients had no additional embolization. The mean sclerosant dwell time in patients with additional embolization was 30 minutes (range 5 – 50 min). Of the 22 patients, 7 were lost to follow-up. The mean period of follow-up was 15.6 months (range 0.1–48 months). Of the 15 remaining patients, 14 (93%) experienced no rebleeding from the treated gastric varices. One patient underwent repeat BRTO procedure due to recurrent variceal bleeding 6 days after initial BRTO. One patient experienced bleeding from esophageal varices after undergoing BRTO. Eight patients underwent follow-up endoscopy and were noted to have significantly improved or no evidence of gastric varices. 

Our preliminary results suggest that BRTO can be safely performed with sclerosant (balloon) dwell times of less than or equal to one hour with outcomes similar to those reported with longer dwell times. 

BRTO can be safely performed with sclerosant (balloon) dwell times of less than or equal to one hour.

Commander, C, Yu, H, Isaacson, A, Mauro, M, Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices with Short Dwell Time of Sclerosant: Results from a Single Center.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003935.html