Letter to the Editor: Is BRTO Superior to Endoscopic Cyanoacrylate in Gastric Varices?

Hepatology. 2021 Apr 8. doi: 10.1002/hep.31853. Online ahead of print.


We read with interest the study by Luo et al. comparing cyanoacrylate (CA) injection with balloon-occluded retrograde transvenous obliteration (BRTO) for the prevention of rebleed from gastric varices (GVs).(1) However, several issues need to be addressed. Although GV size has consistently been shown to be a significant risk factor for bleeding,(2) the authors have not described the size and morphology of the GVs. Patients in the BRTO arm only underwent preprocedural contrast-enhanced computed tomography (CECT) to delineate the shunt and variceal anatomy (Supplementary Fig. a).

Publication types

  • Letter