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Efficacy and Technical Feasibility of Plug-Assisted Retrograde Transvenous Obliteration of Gastric Varices via Pathways Other than the Gastrorenal Shunt

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Abstract

Purpose

To evaluate the efficacy and technical feasibility of plug-assisted retrograde transvenous obliteration of gastric varices via pathways different from the typical gastrorenal shunt.

Materials and methods

We retrospectively reviewed the medical records of 130 patients who underwent plug-assisted retrograde transvenous obliteration for gastric varices between 2013 and 2022. Eight patients underwent plug-assisted retrograde transvenous obliteration via different pathways. We evaluated the types of portosystemic shunts in these patients, the procedure technical and clinical success rates, and clinical outcomes.

Results

In these eight patients (6 males, 2 females; mean age = 60 ± 6 years), the most common type of portosystemic shunt was a gastrocaval shunt (n = 7). Five patients had a gastrocaval shunt only; two had coexisting gastrocaval and gastrorenal shunts. One patient had a pericardiacophrenic shunt without a gastrorenal or gastrocaval shunt. The mean procedure time was 55 min. For patients with a gastrocaval shunt alone (n = 5), the mean procedure time was 40.8 min. The technical and clinical success rates were 100%. No major complication related to the procedure occurred. An initial follow-up computed tomography was performed within 2–3 weeks in all patients and revealed complete thrombosis of the gastric varices. Subsequent follow-up computed tomography (interval: 2–6 months) was performed in seven patients and showed complete disappearance of the gastric varices in all patients. During the follow-up period (range: 42 days-6.25 years), no patients experienced rebleeding or recurrence of gastric varices.

Conclusion

Plug-assisted retrograde transvenous obliteration via alternative portosystemic shunts is effective and technically feasible in the treatment of gastric varices.

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Funding

This study was supported by the Soonchunhyang University Research Fund.

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Authors and Affiliations

  1. Department of Radiology, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, 170, Jomaru-Ro, Bucheon-Si, Gyeonggi-do, 14584, Republic of Korea

    Jongjoon Shim & Jae Myeong Lee

  2. Department of Radiology, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, Gangwon-do, Republic of Korea

    Youngjong Cho

  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Gyeonggi-do, Republic of Korea

    Young Seok Kim, Sang Gyune Kim & Jeong-Ju Yoo

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  1. Jongjoon Shim
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  2. Jae Myeong Lee
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  3. Youngjong Cho
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  4. Young Seok Kim
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  5. Sang Gyune Kim
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  6. Jeong-Ju Yoo
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Correspondence to Jae Myeong Lee.

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Shim, J., Lee, J.M., Cho, Y. et al. Efficacy and Technical Feasibility of Plug-Assisted Retrograde Transvenous Obliteration of Gastric Varices via Pathways Other than the Gastrorenal Shunt. Cardiovasc Intervent Radiol 46, 664–669 (2023). https://doi.org/10.1007/s00270-023-03416-y

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  • DOI: https://doi.org/10.1007/s00270-023-03416-y

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