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Digestive Disease Interventions 2017; 01(04): 286-292
DOI: 10.1055/s-0037-1620280
DOI: 10.1055/s-0037-1620280
Review Article
Balloon-Occluded Retrograde Transvenous Obliteration: Emergence as a Treatment for Gastric Varices and Medically Refractory Hepatic Encephalopathy
Further Information
Publication History
04 December 2017
07 December 2017
Publication Date:
19 January 2018 (online)
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.
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