Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices: A 10-year experience

Tomohiko Akahoshi, Makoto Hashizume, Morimasa Tomikawa, Hirofumi Kawanaka, Shohei Yamaguchi, Kouzo Konishi, Nao Kinjo, Yoshihiko Maehara

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Background and Aim: Balloon-occluded retrograde transvenous obliteration (B-RTO) is a new alternative treatment for gastric varices (GVx), but the long-term efficacy is not known. We investigated the long-term effects of B-RTO on rebleeding, prevention of first bleeding, mortality and occurrence of risky esophageal varices (EVx). Methods: B-RTO was performed in 68 cirrhotic patients with GVx. Twenty patients had recent bleeding, transiently treated by endoscopic Histoacryl injection or balloon tamponade. Forty-eight patients had varices likely to bleed, but no bleeding. After B-RTO, the recurrent bleeding, occurrence of EVx and mortality over the long-term were evaluated. Results: B-RTO was successfully performed in 63 of 68 patients (92.6%). Varices eradication was confirmed by endoscopy in 61 of 63 patients (96.6%). During follow up, GVx bleeding occurred in two patients (3.2%). The 8-year cumulative rebleeding rates of patients with bleeding and risky GVx were 14% and 0%, respectively. Risky EVx occurred in 10 patients (17%) and the cumulative occurrence rate was 22% in 8 years. The cumulative occurrence rate of risky EVx was higher in GVx with EVx (GOV2-GVx) compared to GVx without EVx (IGV1, P < 0.05). No ectopic variceal bleeding occurred. No patients died from variceal bleeding. Hepatocellular carcinoma was the only significant prognostic factor (P < 0.05). Conclusion: B-RTO is beneficial over the long-term, despite worsening EVx in some patients, because of excellent treatment efficacy and improved mortality. We believe that B-RTO can become a first-choice radical treatment following hemostasis for gastric variceal bleeding and prophylactic treatment for risky GVx.

Original languageEnglish
Pages (from-to)1702-1709
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume23
Issue number11
DOIs
Publication statusPublished - Jan 1 2008

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Esophageal and Gastric Varices
antineoplaston A10
Stomach
Hemorrhage
Varicose Veins
Mortality
Enbucrilate
Balloon Occlusion
Hemostasis
Endoscopy
Hepatocellular Carcinoma
Therapeutics
Injections

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices : A 10-year experience. / Akahoshi, Tomohiko; Hashizume, Makoto; Tomikawa, Morimasa; Kawanaka, Hirofumi; Yamaguchi, Shohei; Konishi, Kouzo; Kinjo, Nao; Maehara, Yoshihiko.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 23, No. 11, 01.01.2008, p. 1702-1709.

Research output: Contribution to journalArticle

Akahoshi, Tomohiko ; Hashizume, Makoto ; Tomikawa, Morimasa ; Kawanaka, Hirofumi ; Yamaguchi, Shohei ; Konishi, Kouzo ; Kinjo, Nao ; Maehara, Yoshihiko. / Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices : A 10-year experience. In: Journal of Gastroenterology and Hepatology (Australia). 2008 ; Vol. 23, No. 11. pp. 1702-1709.
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T1 - Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices

T2 - A 10-year experience

AU - Akahoshi, Tomohiko

AU - Hashizume, Makoto

AU - Tomikawa, Morimasa

AU - Kawanaka, Hirofumi

AU - Yamaguchi, Shohei

AU - Konishi, Kouzo

AU - Kinjo, Nao

AU - Maehara, Yoshihiko

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