Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Comparison of Coil Embolization and Slcerotherapy of Collateral Veins during Balloon Occluded Retrograde Transvenous Obliteration: Its Long Term Effect for Gastric Varix Treatment

역행성 경정맥 위정맥류 폐색술시 측부 정맥의 코일 색전술과 경화요법의 비교: 위정맥류 치료에 대한 장기 추적 효과

  • An, Eun-Jung (Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine) ;
  • Kim, Young-Hwan (Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine) ;
  • Kim, See-Hyung (Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine)
  • 안은정 (계명대학교 의과대학 동산의료원 영상의학과학교실) ;
  • 김영환 (계명대학교 의과대학 동산의료원 영상의학과학교실) ;
  • 김시형 (계명대학교 의과대학 동산의료원 영상의학과학교실)
  • Published : 2011.10.01
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Abstract

Purpose: We compared the long term effect gastric varix treatment between coil embolization and sclerotherapy of collateral veins during balloon occluded retrograde transvenous obliteration (BRTO). Materials and Methods: Between February 2004 and November 2008 48 patients with gastric varix bleeding successfully treated with BRTO 23 underwent embolization of collateral veins during BRTO were enrolled in this study. In patients, collateral veins were embolized with the use of microcoil (group 1). Agent (5% ethanolamine oleate + lipiodol) was used in the remaining 7 patients (Group 2). Recurrence and rebleeding of gastric varix were evaluated by endoscopy or CT. Results: Gastric varix recurred in 4 patients (17.4%) and rebleeding occurred in 2 (8.7%). Recurrence (57.1%, p = 0.001) and rebleeding (28.6%, p = 0.029) of gastric occurred in group 2. CT finding within 6 months in partial or complete thrombosis without lipiodol uptake in gastric varix, gastric varix recurred on follow up CT. Conclusion: Coil embolization of collateral veins during BRTO may promote complete obliteration of gastric varix, provide lower recurrence and rebleeding rates of gastric sclerosing agent on long term follow-up.

목적: 위정맥류 출혈 환자에서 역행성 경정맥 위정맥류 폐색술(이하 BRTO)시 시행한 측부 정맥의 코일 색전술과 경화요법 간의 장기 효과를 비교하고자 하였다. 대상과 방법: 2004년 2월부터 2008년 11월까지 위정맥류 출혈의 치료를 위해 BRTO를 성공적으로 시행한 48명의 환자 중 측부 정맥 색전술을 실시한 23명의 환자를 대상으로 하였다. 16명은 미세코일(집단 1)을, 7명은 경화제(5% etha-nolamine oleate + lipiodol, 집단 2)를 이용하여 측부 정맥 색전술을 실시하였다. 전산화단층촬영(이하 CT)과 내시경을 이용하여 위정맥류를 평가하였다. 결과: 위정맥류 재발은 4명(17.4%)에서 발생하였고 2명(8.7%)에서는 재출혈을 보였으며 집단 2에서만 재발(57.1%, p = 0.001)과 재출혈(28.6%, p = 0.029)이 보였다. 재발된 환자들의 6개월 이내 시행한 CT에서 위정맥류 내에 리피오돌 섭취 없이 혈전만이 형성되어 있었고, 추적 CT에서 위정맥류가 재발되었다. 결론: BRTO시 측부 정맥의 코일 색전술은 경화요법에 비해 위정맥류의 완전한 폐색을 일으켜 장기 추적 결과, 재발과 재출혈의 빈도를 낮출 수 있을 것으로 생각된다.

Keywords

References

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