Korean J Radiol.  2014 Feb;15(1):108-113. 10.3348/kjr.2014.15.1.108.

Balloon Occlusion Retrograde Transvenous Obliteration of Gastric Varices in Two Non-Cirrhotic Patients with Portal Vein Thrombosis

Affiliations
  • 1Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA. kims@mir.wustl.edu

Abstract

This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.

Keyword

Balloon occlusion retrograde transvenous obliteration; Portal hypertension; Hemorrhage; Embolization

MeSH Terms

Adult
Balloon Occlusion/*methods
Crohn Disease/surgery
Esophageal and Gastric Varices/*therapy
Female
Humans
*Mesenteric Veins
Middle Aged
Pancreatitis, Acute Necrotizing/complications
*Portal Vein
Venous Thrombosis/*complications

Reference

1. Saad WE, Darcy MD. Transjugular Intrahepatic Portosystemic Shunt (TIPS) versus Balloon-occluded Retrograde Transvenous Obliteration (BRTO) for the Management of Gastric Varices. Semin Intervent Radiol. 2011; 28:339–349.
2. Choi YH, Yoon CJ, Park JH, Chung JW, Kwon JW, Choi GM. Balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding: its feasibility compared with transjugular intrahepatic portosystemic shunt. Korean J Radiol. 2003; 4:109–116.
3. Thompson RJ, Taylor MA, McKie LD, Diamond T. Sinistral portal hypertension. Ulster Med J. 2006; 75:175–177.
4. Kiyosue H, Ibukuro K, Maruno M, Tanoue S, Hongo N, Mori H. Multidetector CT anatomy of drainage routes of gastric varices: a pictorial review. Radiographics. 2013; 33:87–100.
5. Remzi FH, Fazio VW, Oncel M, Baker ME, Church JM, Ooi BS, et al. Portal vein thrombi after restorative proctocolectomy. Surgery. 2002; 132:655–661. discussion 661-662.
6. Yada S, Hizawa K, Aoyagi K, Hashizume M, Matsumoto T, Koga H, et al. Portal hypertensive gastropathy due to chronic portal vein occlusion in Crohn's disease. Am J Gastroenterol. 1998; 93:1376–1377.
7. Gonzelez HJ, Sahay SJ, Samadi B, Davidson BR, Rahman SH. Splanchnic vein thrombosis in severe acute pancreatitis: a 2-year, single-institution experience. HPB (Oxford). 2011; 13:860–864.
8. Bockhorn M, Gebauer F, Bogoevski D, Molmenti E, Cataldegirmen G, Vashist YK, et al. Chronic pancreatitis complicated by cavernous transformation of the portal vein: contraindication to surgery? Surgery. 2011; 149:321–328.
9. Lin YL, Yang PM, Huang GT, Lee TH, Chau SH, Tsang YM, et al. Variceal bleeding due to segmental portal hypertension caused by chronic pancreatitis. Am J Emerg Med. 1995; 13:676–677.
10. Han G, Qi X, He C, Yin Z, Wang J, Xia J, et al. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis. J Hepatol. 2011; 54:78–88.
11. Perarnau JM, Baju A, D'alteroche L, Viguier J, Ayoub J. Feasibility and long-term evolution of TIPS in cirrhotic patients with portal thrombosis. Eur J Gastroenterol Hepatol. 2010; 22:1093–1098.
12. Bilbao JI, Elorz M, Vivas I, Martínez-Cuesta A, Bastarrika G, Benito A. Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of venous symptomatic chronic portal thrombosis in non-cirrhotic patients. Cardiovasc Intervent Radiol. 2004; 27:474–480.
13. Luo J, Yan Z, Wang J, Liu Q, Qu X. Endovascular treatment for nonacute symptomatic portal venous thrombosis through intrahepatic portosystemic shunt approach. J Vasc Interv Radiol. 2011; 22:61–69.
14. Hollingshead M, Burke CT, Mauro MA, Weeks SM, Dixon RG, Jaques PF. Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis. J Vasc Interv Radiol. 2005; 16:651–661.
Full Text Links
  • KJR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2025 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr