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      Retrograde transvenous obliteration of gastric varices.

      Radiology
      Aged, Esophageal and Gastric Varices, radiography, therapy, Female, Humans, Male, Middle Aged, Sclerotherapy, methods

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          Abstract

          To evaluate the clinical efficacy, techniques, and complications associated with balloon-occluded retrograde transvenous obliteration of gastric varices. Between December 1994 and November 1997, balloon-occluded retrograde transvenous obliteration was performed on 20 patients with gastric varices in danger of rupture and with gastrorenal shunts; three patients also had hepatic encephalopathy. The sclerosant was injected into the gastric varices during balloon occlusion. The degree of progression of the gastric varices and of collateral veins was classified into five grades, with grade 1 being least progression and grade 5 most progression; collateral veins that had developed were treated with embolization. Follow-up consisted of fiberoptic endoscopy and computed tomography. Technical success was achieved in all patients. Occlusion of collateral veins was essential for the occlusion of gastric varices with a grade greater than grade 2. The clinical symptoms of hepatic encephalopathy in the three patients improved remarkably. Follow-up endoscopy 3 months after the procedure revealed the disappearance of gastric varices in 15 patients and reduced variceal size in five. During the follow-up period, 19 patients had no recurrence of gastric varices; three patients had aggravation of the esophageal varices. Balloon-occluded retrograde transvenous obliteration is a feasible alternative to a transjugular intrahepatic portosystemic shunt for patients with large gastrorenal shunts or hepatic encephalopathy (or both).

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          Author and article information

          Journal
          10228513
          10.1148/radiology.211.2.r99ma25349

          Chemistry
          Aged,Esophageal and Gastric Varices,radiography,therapy,Female,Humans,Male,Middle Aged,Sclerotherapy,methods
          Chemistry
          Aged, Esophageal and Gastric Varices, radiography, therapy, Female, Humans, Male, Middle Aged, Sclerotherapy, methods

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