Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy

  • Chang, Il Soo (Department of Radiology, Digestive Disease Center, Konkuk University School of Medicine) ;
  • Park, Sang Woo (Department of Radiology, Digestive Disease Center, Konkuk University School of Medicine) ;
  • Kwon, So Young (Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine) ;
  • Choe, Won Hyeok (Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine) ;
  • Cheon, Young Koog (Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine) ;
  • Shim, Chan Sup (Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine) ;
  • Lee, Tae Yoon (Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine) ;
  • Kim, Jeong Han (Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine)
  • Received : 2015.04.10
  • Accepted : 2015.12.16
  • Published : 2016.04.01
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Abstract

Objective: To evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices. Materials and Methods: Between February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44-86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6-33 mL). Patients were followed up using computed tomography (CT) or endoscopy. Results: Technical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality. Conclusion: BRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.

Keywords

Acknowledgement

Supported by : Konkuk University

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