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Vascular Plug-Assisted Retrograde Transvenous Obliteration for the Treatment of Gastric Varices and Hepatic Encephalopathy: A Prospective Multicenter Study

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Author(s)
Dong Il GwonYoung Hwan KimGi-Young KoJong Woo KimHeung Kyu KoJin Hyoung KimJi Hoon ShinHyun-Ki YoonKyu-Bo Sung
Keimyung Author(s)
Kim, Young Hwan
Department
Dept. of Radiology (영상의학)
Journal Title
Journal of Vascular and Interventional Radiology
Issued Date
2015
Volume
26
Issue
11
Abstract
Purpose:

To evaluate technical and clinical outcomes of vascular plug–assisted retrograde transvenous obliteration (PARTO) for the treatment of gastric varices (GVs) and hepatic encephalopathy (HE).


Materials and Methods:

From March 2012 to June 2014, 73 consecutive patients (47 men, 26 women; mean age, 59 y; range, 28–79 y) who had undergone PARTO were evaluated in a prospective multicenter study. Among 57 patients with GVs, 28 had GVs in danger of rupture, 23 had experienced recent bleeding, and 6 had active variceal bleeding. The 16 patients with HE had been treated unsuccessfully with medical therapies.


Results:

Placement of the vascular plug and subsequent gelatin sponge embolization were technically successful in all 73 patients. There were no procedure-related complications. Follow-up CT obtained within 1 wk after PARTO showed complete thrombosis of GVs and portosystemic shunts in 72 of 73 patients (98.6%). Sixty patients who underwent follow-up longer than 3 mo showed complete obliteration of GVs and portosystemic shunts. There were no cases of variceal bleeding or HE at the end of follow-up (mean, 544 d). Improvement in Child–Pugh score was observed in 24 patients (40%) at 1-mo follow-up. Worsening of ascites and esophageal varices was observed in 14 (23.3%) and 16 (26.7%) patients at 3-mo follow-up.


Conclusions:

The present results of PARTO indicate that it can be rapidly performed with high technical success and durable clinical efficacy for the treatment of GVs and HE in the presence of a portosystemic shunt. Therefore, PARTO might be considered a first-line treatment in appropriate patients.
Keimyung Author(s)(Kor)
김영환
Publisher
School of Medicine
Citation
Dong Il Gwon et al. (2015). Vascular Plug-Assisted Retrograde Transvenous Obliteration for the Treatment of Gastric Varices and Hepatic Encephalopathy: A Prospective Multicenter Study. Journal of Vascular and Interventional Radiology, 26(11), 1589–1595. doi: 10.1016/j.jvir.2015.07.011
Type
Article
ISSN
1051-0443
Source
https://www.sciencedirect.com/science/article/pii/S1051044315006892?via%3Dihub
DOI
10.1016/j.jvir.2015.07.011
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33078
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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