Selective Balloon-occluded Retrograde Transvenous Obliteration for Gastric Varices
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- Jogo Atsushi
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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- Nishida Norifumi
- Department of Radiology, Osaka Saiseikai Nakatsu Hospital, Japan
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- Yamamoto Akira
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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- Kageyama Ken
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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- Nakano Mariko
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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- Sohgawa Etsuji
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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- Hamamoto Shinichi
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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- Hamuro Masao
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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- Miki Yukio
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
抄録
<p>Objective Balloon-occluded retrograde transvenous obliteration (B-RTO) for gastric varices (GV) is associated with drawbacks including a postoperative increase in portal pressure and the risk of subsequent worsening of esophageal varices (EV). Selective B-RTO that embolizes only the varices may have the potential to minimize such risks. The aim of this study is to retrospectively compare the postoperative course of patients after selective B-RTO (Group S) and conventional B-RTO (Group B). </p><p>Methods One hundred four patients treated from January 2007 to April 2012 were classified into Groups S (n=5) and B (n=99). In the univariate analysis, the volume of 5% ethanolamine oleate iopamiodol (EOI) administered at baseline and the GV blood flow on endoscopic ultrasound after B-RTO were considered as covariates. The rates of GV recurrence and EV aggravation was also compared between Groups B and S. </p><p>Results In Group S, the volume of 5% EOI was significantly lower (Group S vs. Group B: 14.6±5.5 vs. 28.5±16.4 mL; p=0.0012) and the rate of EV aggravation was lower in comparison to Group B (p=0.045). However, in Group S, the rate of complete eradication of GV blood flow was significantly lower (Group S vs. Group B: 0% vs. 89.9%; p<0.001) and the rate of re-treatment for GV was higher in comparison to Group B (Group S vs. Group B: 60% vs. 1.0%; p<0.001). </p><p>Conclusion Selective B-RTO for GV could minimize the risk of a worsening of EV or reduce the amount of sclerosants; however, the rate of recurrence was high in comparison to conventional B-RTO. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 58 (16), 2291-2297, 2019-08-15
一般社団法人 日本内科学会