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Date Published: 08/07/2022
Online Published: 08/07/2022
Abstract Views: 125
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DOI: https://doi.org/10.55046/vjrnm.36.594.2019
Issue
No. 36 (2019)
Section
Scientific research
How to Cite
Trinh, H. C., Vu, D. L., Pham, M. T., & Ngo, L. L. (2022). Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage in patients with liver cirrhosis. Vietnamese Journal of Radiology and Nuclear Medicine, 36, 19-26. https://doi.org/10.55046/vjrnm.36.594.2019

Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage in patients with liver cirrhosis

Dr Trinh Ha Chau1, Dr Vu Dang Luu1, professor Pham Minh Thong1, Dr Ngo Le Lam2
1 Radiology Center - Bach Mai Hospital
2 Imaging Center - K3 Hospital

Main Article Content

Abstract

Objective: To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension.
Methods: From 2/2017 to 3/2019, 37 patients (8, with history of gastric variceal hemorrhage; 6, active bleeding; 28, risk rupture; 5, ineffective endoscopic interventions) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed.
Conclusion: Plug-assisted retrograde transvenous obliteration is technically and clinically effective for the treatment of gastric varices.
Results: Plug-assisted retrograde transvenous obliteration procedures were technically successful in all 37 patients. There are two cases of combining PARTO with downstream intervention through the portal vein. There are 2 cases of drug release outside the blood vessels during the intervention. 100% of cases use only 1 plug, 3 patients use additional coil (due to large shunt diameter). There were no cases of variceal bleeding during the follow-up.

Article Details

Keywords

cirrhosis, gastric varices, Plug-assisted retrograde transvenous obliteration.

References

1. Boyer T.D., Manns M.P., Sanyal A.J. et al. (2012), Zakim and Boyer’s Hepatology: A Textbook of Liver Disease, Elsevier Health Sciences.
2. Ryan B.M., Stockbrugger R.W., Ryan J.M. (2004). A pathophysiologic, gastroenterologic, and radiologic approach to the management of gastric varices. Gastroenterology, 126(4), 1175–1189.
3. Trudeau W., Prindiville T. (1986). Endoscopic injection sclerosis in bleeding gastric varices. Gastrointest Endosc, 32(4), 264–268.
4. Sarin S.K. (1997). Long-term follow-up of gastric variceal sclerotherapy: an eleven-year experience. Gastrointest Endosc, 46(1), 8–14.
5. Sumon S.M., Sutradhar S.R., Chowdhury M. et al. (2013). Relation of different grades of esophageal varices with Child-Pugh classes in cirrhosis of liver. Mymensingh Med J MMJ, 22(1), 37–41.
6. Kim T., Shijo H., Kokawa H. et al. (1997). Risk factors for hemorrhage from gastric fundal varices. Hepatol Baltim Md, 25(2), 307–312.
7. Gwon D.I., Ko G.-Y., Kwon Y.B. et al. (2018). Plug-Assisted Retrograde Transvenous Obliteration for the
Treatment of Gastric Varices: The Role of Intra-Procedural Cone-Beam Computed Tomography. Korean J Radiol, 19(2), 223–229.
8. Gwon D.I., Kim Y.H., Ko G.-Y. et al. (2015). Vascular Plug-Assisted Retrograde Transvenous Obliteration for the Treatment of Gastric Varices and Hepatic Encephalopathy: A Prospective Multicenter Study. J Vasc Interv Radiol JVIR, 26(11), 1589–1595.