Plug assisted retrograde transvenous obliteration
Overall, minimally invasive procedures have a lower complication rate than open surgeries. This ascending colonic varix was treated by balloon-occluded retrograde transvenous obliteration (B-RTO) using coil-assisted retrograde transvenous obliteration II (CARTO-II) procedure via the right renal vein.
There are complications possible with any medical procedure. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such a discussion. Gastric varices and hepatic encephalopathy: treatment with vascular plug and gelatin sponge-assisted retrograde transvenous obliteration-a primary report. The above information is not all inclusive of the risks, alternatives and benefits.
Hepatic encephalopathy refers to the worsening of brain function that is caused by a damaged liver. You may be advised to undergo this procedure if you are at risk of or already have gastric variceal bleeding and hepatic encephalopathy as well as a gastrorenal shunt. A medication will then be injected into the dilated vessels through the catheter, until they are completely filled.Īnother venography will then be performed, to confirm that the blood flow in the shunt has stopped. This will allow the interventional radiologist to confirm exactly which vessels need to be treated and if there are any other abnormal or dilated vessels which have not previously been identified. The interventional radiologist will then perform a venography, which is a type of imaging technique in which X-rays are used to see the vessels clearly. The catheter is then directed to the gastrorenal or gastrocaval shunt and the blood flow is blocked. The interventional radiologist will insert a catheter (a thin, flexible tube with a tiny balloon at one end) through a vein in your thigh or neck and guide the catheter to the liver using fluoroscopyfor guidance. Balloon-occluded retrograde transvenous obliteration (BRTO) was first introduced by Kanagawa et al. The mortality rate associated with the bleeding from GVs is not low. TIPS aims to relieve the pressure on the dilated vessels by creating new connections between blood vessels in the liver using a shunt. Gastric varices (GVs) are a major complication of portal hypertension in patients with liver cirrhosis. It can be used in addition to or as an alternative to TIPS, which is the primary treatment for gastric varices. The procedure involves blocking the dilated vessels, reducing the risk of rupture. What is retrograde transvenous obliteration?