Balloon-occluded retrograde transvenous obliteration of gastric varices from unconventional systemic veins in the absence of gastrorenal shunts

Tech Vasc Interv Radiol. 2012 Sep;15(3):241-53. doi: 10.1053/j.tvir.2012.07.006.


Balloon-occluded retrograde transvenous obliteration of gastric varices in the absence of a gastrorenal shunts can still be performed through unconventional venous routes, such as the left inferior phrenic (ascending portion or transverse portion), pericardial, and azygous-hemiazygous veins. This requires detailed knowledge of venous anatomy, impeccable preprocedural imaging for planning, and high-skill set techniques with smaller balloon-occlusion catheters. The technical results appear to be high (67%-83% depending on the access venous system available), but are lower than conventional balloon-occluded retrograde transvenous obliteration via the gastrorenal shunt.

Publication types

  • Review

MeSH terms

  • Aged
  • Balloon Occlusion / adverse effects
  • Balloon Occlusion / instrumentation
  • Balloon Occlusion / methods*
  • Catheters
  • Equipment Design
  • Esophageal and Gastric Varices / diagnostic imaging
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / physiopathology
  • Esophageal and Gastric Varices / therapy*
  • Female
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / physiopathology
  • Gastrointestinal Hemorrhage / therapy*
  • Humans
  • Hypertension, Portal / complications*
  • Male
  • Middle Aged
  • Phlebography
  • Radiography, Interventional
  • Regional Blood Flow
  • Treatment Outcome
  • Veins* / abnormalities
  • Veins* / pathology
  • Veins* / physiopathology