Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration
Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration
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DOI：
10.1111/j.1440-1746.1996.tb00010.x
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发表时间：
1996-01-01
影响因子：
4.1
通讯作者：
Okuda, K
中科院分区：
文献类型：
--
作者：
Kanagawa, H;Mima, S;Okuda, K
虽然胃底静脉曲张在门静脉高压中不像食道静脉曲张那么常见，但当胃底静脉曲张破裂时，死亡率更高。他们不太适合硬化疗法。我们已经开发了一种微创球囊闭塞逆行横切面闭塞术（B-RTO）来治疗胃底静脉曲张。B-RTO包括将球囊导管插入经股静脉或颈内静脉的流出分流（胃-肾静脉或胃-下腔静脉）。然后通过充气球囊阻断血液流动，并以逆行方式注射5%乙醇胺油酸iopamidol。栓塞的胃静脉曲张随后消失。对32例胃静脉曲张患者行B-RTO手术。随访时间2 ~ 4个月，平均观察时间14个月。在32例患者中，31例已确认静脉曲张根除。随访期间无复发病例发生。术后肝功能无明显变化。我们认为B-RTO是一种安全有效的治疗胃底静脉曲张的方法。
Although less common than oesophageal varices in portal hypertension, gastric fundal varices carry a higher mortality rate when they rupture. They are less amenable to sclerotherapy. We have developed a minimally invasive balloon-occluded retrograde transverse obliteration (B-RTO) procedure to treat gastric fundal varices. B-RTO involves inserting a balloon catheter into an outflow shunt (gastric-renal or gastric-vena caval inferior) via the femoral or internal jugular vein. Blood flow is then blocked by inflating the balloon, and 5% ethanolamine oleate iopamidol is injected in a retrograde manner. The embolized gastric varix subsequently disappears. B-RTO was performed in 32 patients with gastric varices. Follow-up endoscopies were performed at intervals of 2-4 months for an average observation period of 14 months. Eradication of the varices has been confirmed in 31 of 32 patients. No recurrence occurred in any patients in the follow-up period. There were no significant changes in liver function after the procedure. We conclude that B-RTO is a safe and effective procedure for the treatment of gastric fundal varices.