Clinical outcomes of balloon-occluded retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage in Korean patients with liver cirrhosis: a retrospective multicenter study.
10.3350/cmh.2012.18.4.368
- Author:
Se Young JANG
1
;
Go Heun KIM
;
Soo Young PARK
;
Chang Min CHO
;
Won Young TAK
;
Jeong Han KIM
;
Won Hyeok CHOE
;
So Young KWON
;
Jae Myeong LEE
;
Sang Gyune KIM
;
Dae Yong KIM
;
Young Seok KIM
;
Se Ok LEE
;
Yang Won MIN
;
Joon Hyeok LEE
;
Seung Woon PAIK
;
Byung Chul YOO
;
Jae Wan LIM
;
Hong Joo KIM
;
Yong Kyun CHO
;
Joo Hyun SOHN
;
Jae Yoon JEONG
;
Yu Hwa LEE
;
Tae Yeob KIM
;
Young Oh KWEON
Author Information
1. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. yokweon@mail.knu.ac.kr
- Publication Type:Multicenter Study ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Balloon-occluded retrograde transvenous obliteration;
Esophageal varices;
Gastric varices;
Liver cirrhosis;
Variceal hemorrhage
- MeSH:
Adult;
Aged;
Asian Continental Ancestry Group;
*Balloon Occlusion/adverse effects;
Endoscopy, Gastrointestinal;
Esophageal and Gastric Varices/*complications;
Female;
Follow-Up Studies;
Gastrointestinal Hemorrhage/etiology/prevention & control/*therapy;
Humans;
Liver Cirrhosis/*complications;
Male;
Middle Aged;
Odds Ratio;
Pulmonary Embolism/etiology;
Recurrence;
Republic of Korea;
Retrospective Studies;
Severity of Illness Index;
Treatment Outcome
- From:Clinical and Molecular Hepatology
2012;18(4):368-374
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: This study evaluated the clinical outcomes of balloon-occluded retrograde transvenous obliteration (BRTO) for the treatment of hemorrhage from gastric varices (GV) in Korean patients with liver cirrhosis (LC). METHODS: We retrospectively analyzed data from 183 LC patients who underwent BRTO for GV bleeding in 6 university-based hospitals between January 2001 and December 2010. RESULTS: Of the 183 enrolled patients, 49 patients had Child-Pugh (CP) class A LC, 105 had CP class B, and 30 had CP class C at the time of BRTO. BRTO was successfully performed in 177 patients (96.7%). Procedure-related complications (e.g., pulmonary thromboembolism and renal infarction) occurred in eight patients (4.4%). Among 151 patients who underwent follow-up examinations of GV, 79 patients (52.3%) achieved eradication of GV, and 110 patients (72.8%) exhibited marked shrinkage of the treated GV to grade 0 or I. Meanwhile, new-appearance or aggravation of esophageal varices (EV) occurred in 54 out of 136 patients who underwent follow-up endoscopy (41.2%). During the 36.0+/-29.2 months (mean+/-SD) of follow-up, 39 patients rebled (hemorrhage from GV in 7, EV in 18, nonvariceal origin in 4, and unknown in 10 patients). The estimated 3-year rebleeding-free rate was 74.8%, and multivariate analysis showed that CP class C was associated with rebleeding (odds ratio, 2.404; 95% confidence-interval, 1.013-5.704; P=0.047). CONCLUSIONS: BRTO can be performed safely and effectively for the treatment of GV bleeding. However, aggravation of EV or bleeding from EV is not uncommon after BRTO; thus, periodic endoscopy to follow-up of EV with or without prophylactic treatment might be necessary in LC patients undergoing BRTO.
