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Comparison of Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Using Ethanolamine Oleate (EO), BRTO Using Sodium Tetradecyl Sulfate (STS) Foam and Vascular Plug-Assisted Retrograde Transvenous Obliteration (PARTO)

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Abstract

Purpose

To compare the clinical outcomes of balloon-occluded retrograde transvenous obliteration (BRTO) using ethanolamine oleate (EO), BRTO using sodium tetradecyl sulfate (STS) foam, and vascular plug-assisted retrograde transvenous obliteration (PARTO).

Materials and Methods

From April 2004 to February 2015, ninety-five patients underwent retrograde transvenous obliteration for gastric varices were analyzed retrospectively. BRTO with EO was performed in 49 patients, BRTO with STS foam in 25, and PARTO in 21. Among them, we obtained follow-up data in 70 patients. Recurrence of gastric varices was evaluated by follow-up endoscopy or CT. Medical records were reviewed for the clinical efficacy. Statistical analyses were performed by Kaplan–Meier method, Chi-square, Fisher’s, and Kruskal–Wallis tests.

Results

Technical and clinical success was 94.7 %. As major complications, a hemoglobinuria and a death due to disseminated intravascular coagulation (DIC) were occurred in two patients with BRTO using EO. Recurrence occurred more frequently in PARTO group (P < 0.05). Recurrence occurred in three patients in BRTO using EO group and four patients in PARTO group with 3.2 and 32.8 % of each expected 1-year recurrence rates. There was no recurrence in BRTO using STS group. Abdominal pain occurred more frequently in BRTO using EO than BRTO using STS foam and PARTO (P < 0.05). Procedure time of PARTO was shorter than two conventional BRTOs (P < 0.05).

Conclusions

BRTO using STS foam or PARTO is better than BRTO using EO for treatment of gastric varices in terms of complication or procedure time. However, PARTO showed frequent recurrence of gastric varices during the long-term follow-up rather than BRTO.

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Authors and Affiliations

  1. Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, 56 Dalseong-Ro, Jun-Gu, Daegu, 700-712, Korea

    Young Hwan Kim, Young Hwan Kim, Chan Sun Kim, See Hyung Kim & Joo Hwan Kim

  2. Department of Radiology, Daegu Catholic University Medical Center, Daegu, Korea

    Ung Rae Kang

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  1. Young Hwan Kim
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  2. Young Hwan Kim
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  3. Chan Sun Kim
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  4. Ung Rae Kang
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  5. See Hyung Kim
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  6. Joo Hwan Kim
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Correspondence to Young Hwan Kim.

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All procedures performed in studies involving medical records were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kim, Y.H., Kim, Y.H., Kim, C.S. et al. Comparison of Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Using Ethanolamine Oleate (EO), BRTO Using Sodium Tetradecyl Sulfate (STS) Foam and Vascular Plug-Assisted Retrograde Transvenous Obliteration (PARTO). Cardiovasc Intervent Radiol 39, 840–846 (2016). https://doi.org/10.1007/s00270-015-1288-8

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  • DOI: https://doi.org/10.1007/s00270-015-1288-8

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