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Digestive Disease Interventions 2017; 01(04): 286-292
DOI: 10.1055/s-0037-1620280
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Balloon-Occluded Retrograde Transvenous Obliteration: Emergence as a Treatment for Gastric Varices and Medically Refractory Hepatic Encephalopathy

Ronnie C. Chen
1   Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California
,
Edward Wolfgang Lee
1   Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California
,
Sung Ki Cho
2   Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
› Author Affiliations
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Publication History

04 December 2017

07 December 2017

Publication Date:
19 January 2018 (online)

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Abstract

Gastric or esophageal variceal bleeding is a major complication of portal hypertension in patients with liver cirrhosis. Currently, liver transplant is still considered a gold standard treatment for gastric or esophageal variceal bleeding. What about varices associated with splenic vein thrombosis? In the United States and Europe, endoscopic treatment and transjugular intrahepatic portosystemic shunt (TIPS) have been considered as effective treatment options for these variceal bleeding. However, in South Korea and Japan, balloon-occluded retrograde transvenous obliteration (BRTO) has been considered as a well-accepted treatment option for the gastric variceal bleeding. In recent years, based on favorable outcomes of BRTO in Asia and unfavorable outcomes/complications of TIPS, BRTO has emerged as an alternative therapy for gastric varices in the Western world. In this review, we describe the indications/contraindications, techniques, and outcomes of BRTO.

Keywords

BRTO - gastric variceal bleeding - TIPS - hepatic encephalopathy
 

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