![]() ![]() Balloon-occluded transvenous obliteration from the systemic veins is referred to as balloon-occluded retrograde transvenous obliteration (BRTO), and balloon-occluded transvenous obliteration from the portal veins is referred to as balloon-occluded antegrade transvenous obliteration (BATO) ( Fig. 5īecause many variceal systems have multiple feeding and multiple draining pathways, combinations of antegrade and retrograde techniques are frequently useful. 4 Chemical-based sclerosis of varices, although frequently resulting in worsened PHT, have proven to be very effective in eradicating the varices at risk. 3 Embolization of varices using macroscopic coils or glue is commonly recommended but also fails to eliminate this risk entirely. 2 Additionally, even with a lowered portosystemic gradient, high-risk varices, such as those found in the gastric antrum, may still be at risk of hemorrhage. 1 Endovascular and surgical portosystemic shunting procedures are effective at reducing the portal pressure but may result in serious complications such as encephalopathy or hepatic insufficiency. Chapter 30: Balloon-Occluded Antegrade Transvenous Obliteration and Variations of Balloon-Occluded Retrograde Transvenous Obliteration in the Treatment of Gastric Varicesĭevastating hemorrhage from portosystemic varices remains a major cause of morbidity and mortality in patients with portal hypertension (PHT). ![]()
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