Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration

J Gastroenterol Hepatol. 1996 Jan;11(1):51-8. doi: 10.1111/j.1440-1746.1996.tb00010.x.


Although less common than oesophageal varices in portal hypertension, gastric fundal varices carry a higher mortality rate when they rupture. They are less amenable to sclerotherapy. We have developed a minimally invasive balloon-occluded retrograde transverse obliteration (B-RTO) procedure to treat gastric fundal varices. B-RTO involves inserting a balloon catheter into an outflow shunt (gastric-renal or gastric-vena caval inferior) via the femoral or internal jugular vein. Blood flow is then blocked by inflating the balloon, and 5% ethanolamine oleate iopamidol is injected in a retrograde manner. The embolized gastric varix subsequently disappears. B-RTO was performed in 32 patients with gastric varices. Follow-up endoscopies were performed at intervals of 2-4 months for an average observation period of 14 months. Eradication of the varices has been confirmed in 31 of 32 patients. No recurrence occurred in any patients in the follow-up period. There were no significant changes in liver function after the procedure. We conclude that B-RTO is a safe and effective procedure for the treatment of gastric fundal varices.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Catheterization*
  • Esophageal and Gastric Varices / diagnostic imaging
  • Esophageal and Gastric Varices / therapy*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Endoscopic
  • Humans
  • Male
  • Middle Aged
  • Oleic Acids / therapeutic use*
  • Radiography
  • Sclerosing Solutions / therapeutic use*
  • Sclerotherapy / methods
  • Time Factors


  • Oleic Acids
  • Sclerosing Solutions
  • ethanolamine oleate