plug assisted retrograde transvenous obliteration

11,12 Bleeding GV which was not achieved primary hemostasis cases were excluded. Treatment criteria for GV were as follows: isolated varices which are moderately enlarged, beady form, or markedly enlarged, nodular, tumor-shaped form, and/or red spot as defined by the Japan Gastroenterological Endoscopy Society. 2,9 The purpose of this study is to examine the utility of 5% ethanolamine oleate iopamidol (EOI) with low-dose gelatin sponge particles mixture as sclerosants in B-RTO. The author of PARTO is 100% obliteration of gastric varices (GV) at 6 months however, Gwon et al mentions that recurrence is higher compared with EO-based treatment, standing at 32.8% after 1 year. 10 Recurrence of varices, however, is controversial. 9 It is technically easier to perform and can decrease procedure time because it does not require a balloon catheter and does not perform selective embolization of collateral efferent veins. Both these situations increase the time required to complete the procedure.įirst introduced in 2013, PARTO is a new modality that uses GS particles as a embolic agent. Selective catheter insertion into the vessels to be embolized is difficult in some patients, and larger amounts of sclerosant must be used when many narrow draining veins are present. 8 Draining veins are therefore often embolized with a coil before treatment to downgrade the lesion. Hirota’s classification of high-grade), since the agent could escape before embolization is achieved in an amount exceeding the tolerable level. It is therefore unsuited for large-volume varices with substantial collateral draining veins ( i.e. 7 EO functions well as sclerosants but has the maximum tolerable amount. The vessel is eventually obstructed due to the accumulation of platelets and fibrin on damaged endothelium and mural thrombi. 1 EO induces thrombus formation by directly damaging the venous endothelium.

5–7 B-RTO with EO has been in use since the 1996 by Kanagawa. 1–4ĮO was first applied as a sclerosant against esophageal varices by Trolle and Patterson in 1946. Embolic agents used for gastric varix sclerotherapy in balloon-occluded retrograde transvenous obliteration (B-RTO) include ethanolamine oleate (EO), polidocanol foam, sodium tetradecyl sulfate (STS), ethanol, N-butyl-2-cyanoacrylate (NBCA), and, more recently, contrast agents containing gelatin sponge (GS) particles to achieve plug-assisted retrograde transvenous obliteration (PARTO).

Plug assisted retrograde transvenous obliteration