Balloon-assisted percutaneous transhepatic variceal embolization with cyanoacrylate for treatment of isolated gastric varices

Abstract

Objective \nTo evaluate the effectiveness and safety of percutaneous transhepatic variceal embolization(PTVE)with cyanoacrylate assisted with balloon for the treatment of isolated gastric varice(IGV)with gastrorenal shunt(GRS). \n \n \nMethods \nThirty patients with IGV associated with GRS who underwent balloon-assisted PTVE after shunt balloon occlusion via renal vein in Department of Gastroenterology of Shandong Provincial Hospital Affiliated to Shandong University between March 2010 and June 2015 were retrospectively analyzed.The technical success rate, clinical success rate, complications and follow-up were summarized. \n \n \nResults \nBalloon-assisted PTVE was technically successful in all 30 patients.No serious complications were observed except for one nonsymptomatic pulmonary embolism.During a mean follow-up of 30 months, re-bleeding was observed in 4/30(13.3%)patients, worsening of esophageal varices was observed in 4/30(13.3%)patients, and newly developed or aggravated ascites were observed in 3/30(10%)patients.The 1-, 2-, 3-and 5-year cumulative survival rates were 96.3%, 96.3%, 79.9% and 79.9%, respectively. \n \n \nConclusion \nBalloon-assisted PTVE with cyanoacrylate is technically feasible, safe and effective for the treatment of IGV associated with GRS, and it is an useful alternative scheme. \n \n \nKey words: \nPortal hypertension;\xa0Isolated gastric varices;\xa0Gastrorenal shunts;\xa0Percutaneous transhepatic variceal embolization