|
KMID : 1103720160750020092
|
|
Journal of the Korean Society of Radiology
2016 Volume.75 No. 2 p.92 ~ p.103
|
|
|
Vascular Plug-Assisted Retrograde Transvenous Obliteration for the Management of Gastric Varices: Comparative Effectiveness between Gelatin Sponge Embolization and Permanent Sclerosant
|
|
Lee Ji-Hyun
Jo Jeong-Hyun
Park Jae-Hyung
Jung Gyoo-Sik
Park Byeong-Ho
|
|
|
Abstract
|
|
|
Purpose: To evaluate the short-term outcome of plug-assisted retrograde transvenous obliteration (PARTO) using vascular plugs and gelatin sponges in comparison with balloon-occluded retrograde transvenous obliteration (BRTO) for the management of gastric varices.
Materials and Methods: From January 2005 to October 2014, 171 patients were referred for management of gastric varices, of which, 52 patients with hemodynamically stable gastric varices (48 recent bleeding; 4 primary prophylaxes) were evaluated. Of these, 38 received BRTO (men/women 23/15; mean age 61.3; Child-Pugh classes A/B/C = 11/25/2) and 14 underwent PARTO (men/women 11/3; mean age 63.4; Child-Pugh classes A/B/C = 9/4/1). The technical success rate, complications, variceal changes, liver function, and exacerbation of ascites/pleural effusion were compared between the 2 groups within 3 months after the procedure.
Results: The technical success rates were 92.1% in the BRTO and 100% in the PARTO group. Procedure-related early complications occurred in the BRTO group alone (8%, n = 3). Among patients with technical success, follow-up CT at 1 month was available for 98% (n = 48/49). Complete thrombosis of gastric varices was achieved in 97.1% in the BRTO and 100% in the PARTO group. Worsening of esophageal varices was observed in 24% of the BRTO group alone (n = 8). The albumin level increased significantly in both groups and aspartate aminotransferase/alanine aminotransferase level improved significantly in the PARTO group (p < 0.05). Exacerbation of ascites/pleural effusion was observed in both groups (35.2% vs. 21.4%, both p > 0.05).
Conclusion: PARTO appears to be equivalent to BRTO for short-term management of gastric varices.
|
|
|
KEYWORD
|
|
|
Gelatin Sponges, Absorbable, Esophageal and Gastric Varices, Balloon Occlusion, Gastrointestinal Hemorrhage
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|