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Efficacy and safety of balloon-occluded retrograde transvenous obliteration of gastric varices with lauromacrogol foam sclerotherapy: initial experience

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Abstract

Purpose

Balloon-occluded retrograde transvenous obliteration (BRTO) is a widely-accepted treatment for gastric varices (GVs). The purpose of this study was to evaluate the efficacy and safety of BRTO with lauromacrogol foam sclerotherapy.

Materials and methods

Between May 2014 and June 2015, 32 patients were treated with lauromacrogol foam. Lauromacrogol foam was made using a combination of agents, with a 2:1:1 ratio of room air: lauromacrogol: contrast media. Patients were followed up using contrast-enhanced computed tomography (CT) and endoscopy.

Results

Technical success was achieved in 31 of 32 patients (96.9%). Portal vein thrombosis occurred in two patients and resolved spontaneously. No other major complications were observed. The overall mean dose of lauromacrogol used was 12.4 mL (range, 8–20 mL). Complete obliteration of GVs was confirmed in all 31 patients (100%) on follow-up CT. Seven of the 31 patients (22.6%) experienced worsening of esophageal varices. Rupture of esophageal varices occurred in three patients and was treated successfully with band ligation. Five patients (16.1%) experienced worsening of ascites and responded well to diuretic therapy.

Conclusion

BRTO utilizing lauromacrogol foam appears to be a safe and useful treatment option in patients with GVs in the short term.

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Acknowledgments

This work was supported by grants (81570554 & 81501566) from National Natural Science Foundation of China.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, People’s Republic of China

    Xuefeng Luo, Ying Zhao & Li Yang

  2. Center of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, China

    Xuefeng Luo, Huaiyuan Ma, Jiaze Yu & Xiaoze Wang

Authors
  1. Xuefeng Luo
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  2. Huaiyuan Ma
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  3. Jiaze Yu
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  4. Ying Zhao
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  5. Xiaoze Wang
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  6. Li Yang
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Correspondence to Li Yang.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants 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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Informed consent was obtained from all individual participants included in the study.

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Luo, X., Ma, H., Yu, J. et al. Efficacy and safety of balloon-occluded retrograde transvenous obliteration of gastric varices with lauromacrogol foam sclerotherapy: initial experience. Abdom Radiol 43, 1820–1824 (2018). https://doi.org/10.1007/s00261-017-1346-6

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  • DOI: https://doi.org/10.1007/s00261-017-1346-6

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