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Roles of contrast-enhanced MSCT in indication of vascular PARTO for cirrhotic patients with gastric varices
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Abstract
SUMMARY
Esophageal varicose veins are the main cause of high GI bleeding in cirrhotic patients. Plug – assisted retrograde transvenous obliteration
(PARTO) is a safe, minimally invasive, effective hemostasis technique
and prevent recurrence in gastric variceal hemorrhage/ gastric varices that has been widely deployed in many countries such as Japan and Korea. Multislice Computer Tomography (MSCT) that provides complete
information about the features of gastric varicose buns is the method that should be performed prior to PARTO intervention.
Objectives: 1. Characterization of gastric varicose buns on multiseries computed tomography and Kiyosue classification. 2. Comparing multi-sequence computed tomography with DSA image of gastric varicose tufts in patients with PARTO retrograde intervention.
Methods: The study was conducted retrospectively and with crosssectional descriptions of 91 patients with cirrhosis and gastric varices admitted to the hospital because of gastrointestinal bleeding were taken MSCT in the period from April 2018 to July 2020.
Conclusion: Among 91 cases of gastric varices; the majority of gastric veins dilated to an average of 5-10 mm (51 patients), supplied
mainly from the left gastric vein (84 patients) and drained to the esophageal veins (60 patients). The diameter of the dilated gastric vein measured on the MSCT was correlated with the number of afferent portal venous feeders and not with the number of efferent systemic venous drainage. The major gastric varicose tufts fall under the type 2B classification (~ 22%). Out of 91 cases, there were 58 cases with gastrorenal shunt, 2 cases with gastrocaval shunt, of which 21 cases of severe gastrointestinal bleeding required PARTO intervention; There were 2 cases where there was no renal shunt but had severe gastrointestinal bleeding, PVTO. For the PARTO intervention group, the renal shunt diameter measured on CLVT and measured on the DSA did not differ with p = 0.083.
Results: The gastric varicose buns is mainly supplied with blood
from the left gastric vein, and drained by the esophageal vein and the kidney shunt. Examination of imaging of gastric varicose buns is necessary to determine whether PARTO is indicated, to select the right
materials and to effectively predict of PARTO interventions.
Article Details
Keywords
cirrhosis, gastric varices, Plug – assisted retrograde transvenous obliteration
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