Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes

Our aim was to evaluate the long-term efficacy and safety of percutaneous transhepatic obliteration (PTO) alone and combined with balloon-occluded retrograde transvenous obliteration (BRTO) for gastroesophageal varices refractory to BRTO alone. Between July 1999 and December 2010, 13 patients with g...

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Main Authors: Fumio Uchiyama, Satoru Murata, Shiro Onozawa, Ken Nakazawa, Fumie Sugihara, Daisuke Yasui, Yoshiyuki Narahara, Eiji Uchida, Yasuo Amano, Shin-ichiro Kumita
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2013/498535
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author Fumio Uchiyama
Satoru Murata
Shiro Onozawa
Ken Nakazawa
Fumie Sugihara
Daisuke Yasui
Yoshiyuki Narahara
Eiji Uchida
Yasuo Amano
Shin-ichiro Kumita
author_facet Fumio Uchiyama
Satoru Murata
Shiro Onozawa
Ken Nakazawa
Fumie Sugihara
Daisuke Yasui
Yoshiyuki Narahara
Eiji Uchida
Yasuo Amano
Shin-ichiro Kumita
author_sort Fumio Uchiyama
collection DOAJ
description Our aim was to evaluate the long-term efficacy and safety of percutaneous transhepatic obliteration (PTO) alone and combined with balloon-occluded retrograde transvenous obliteration (BRTO) for gastroesophageal varices refractory to BRTO alone. Between July 1999 and December 2010, 13 patients with gastroesophageal varices refractory to BRTO were treated with PTO (n = 6) or a combination of PTO and BRTO (n = 7). We retrospectively investigated the rates of survival, recurrence, or worsening of the varices; hepatic function before and after the procedure; and complications. The procedure achieved complete obliteration or significant reduction of the varices in all 13 patients without major complications. During follow-up, the varices had recurred in 2 patients, of which one had hepatocellular carcinoma, and the other died suddenly from variceal rebleeding 7 years after PTO. The remaining 11 patients did not experience worsening of the varices and showed significant improvements in the serum ammonia levels and prothrombin time. The mean follow-up period was 90 months, and the cumulative survival rate at 1, 3, and 5 years was 92.9%, 85.7%, and 85.7%, respectively. Both PTO and combined PTO and BRTO seem as safe and effective procedures for the treatment of gastroesophageal varices refractory to BRTO alone.
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spelling doaj-art-091d3d83d07e4a1cb7f35b7d8e1464352025-08-20T02:03:24ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/498535498535Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and OutcomesFumio Uchiyama0Satoru Murata1Shiro Onozawa2Ken Nakazawa3Fumie Sugihara4Daisuke Yasui5Yoshiyuki Narahara6Eiji Uchida7Yasuo Amano8Shin-ichiro Kumita9Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanDivision of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanDepartment of Radiology, Nippon Medical School, 1-1-5 Sendagi, Center for Advanced Medical Technology, Bunkyou-ku, Tokyo 113-8603, JapanOur aim was to evaluate the long-term efficacy and safety of percutaneous transhepatic obliteration (PTO) alone and combined with balloon-occluded retrograde transvenous obliteration (BRTO) for gastroesophageal varices refractory to BRTO alone. Between July 1999 and December 2010, 13 patients with gastroesophageal varices refractory to BRTO were treated with PTO (n = 6) or a combination of PTO and BRTO (n = 7). We retrospectively investigated the rates of survival, recurrence, or worsening of the varices; hepatic function before and after the procedure; and complications. The procedure achieved complete obliteration or significant reduction of the varices in all 13 patients without major complications. During follow-up, the varices had recurred in 2 patients, of which one had hepatocellular carcinoma, and the other died suddenly from variceal rebleeding 7 years after PTO. The remaining 11 patients did not experience worsening of the varices and showed significant improvements in the serum ammonia levels and prothrombin time. The mean follow-up period was 90 months, and the cumulative survival rate at 1, 3, and 5 years was 92.9%, 85.7%, and 85.7%, respectively. Both PTO and combined PTO and BRTO seem as safe and effective procedures for the treatment of gastroesophageal varices refractory to BRTO alone.http://dx.doi.org/10.1155/2013/498535
spellingShingle Fumio Uchiyama
Satoru Murata
Shiro Onozawa
Ken Nakazawa
Fumie Sugihara
Daisuke Yasui
Yoshiyuki Narahara
Eiji Uchida
Yasuo Amano
Shin-ichiro Kumita
Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes
The Scientific World Journal
title Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes
title_full Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes
title_fullStr Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes
title_full_unstemmed Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes
title_short Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes
title_sort management of gastric varices unsuccessfully treated by balloon occluded retrograde transvenous obliteration long term follow up and outcomes
url http://dx.doi.org/10.1155/2013/498535
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