Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study
Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2022-04-01
|
| Series: | Journal of Clinical Interventional Radiology ISVIR |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728998 |
| _version_ | 1818365944267800576 |
|---|---|
| author | Pushpinder S. Khera Pawan K. Garg Sarbesh Tiwari Narendra Bhargava Taruna Yadav Binit Sureka Tushar Ghosh Santhosh Babu Sunil Dadhich Surjit Singh |
| author_facet | Pushpinder S. Khera Pawan K. Garg Sarbesh Tiwari Narendra Bhargava Taruna Yadav Binit Sureka Tushar Ghosh Santhosh Babu Sunil Dadhich Surjit Singh |
| author_sort | Pushpinder S. Khera |
| collection | DOAJ |
| description | Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol.
Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied.
Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications.
Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate. |
| first_indexed | 2024-12-13T22:28:18Z |
| format | Article |
| id | doaj.art-52a9a85fb8c14a13ae893a9a0b36904f |
| institution | Directory Open Access Journal |
| issn | 2456-4869 |
| language | English |
| last_indexed | 2024-12-13T22:28:18Z |
| publishDate | 2022-04-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Journal of Clinical Interventional Radiology ISVIR |
| spelling | doaj.art-52a9a85fb8c14a13ae893a9a0b36904f2022-12-21T23:29:08ZengThieme Medical Publishers, Inc.Journal of Clinical Interventional Radiology ISVIR2456-48692022-04-01601101710.1055/s-0041-1728998Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective StudyPushpinder S. Khera0Pawan K. Garg1Sarbesh Tiwari2Narendra Bhargava3Taruna Yadav4Binit Sureka5Tushar Ghosh6Santhosh Babu7Sunil Dadhich8Surjit Singh9Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaDepartment of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaDepartment of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaDepartment of Gastroenterology, Dr S N Medical College, Jodhpur, Rajasthan, IndiaDepartment of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaDepartment of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaDepartment of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaDepartment of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaDepartment of Gastroenterology, Dr S N Medical College, Jodhpur, Rajasthan, IndiaDepartment of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaIntroduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol. Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied. Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications. Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728998bleeding gastric varicesretrograde transvenous obliterationballoon-occluded retrograde transvenous obliterationplug-assisted retrograde transvenous obliterationgastrorenal shunthepatic encephalopathysodium tetradecyl sulfate |
| spellingShingle | Pushpinder S. Khera Pawan K. Garg Sarbesh Tiwari Narendra Bhargava Taruna Yadav Binit Sureka Tushar Ghosh Santhosh Babu Sunil Dadhich Surjit Singh Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study Journal of Clinical Interventional Radiology ISVIR bleeding gastric varices retrograde transvenous obliteration balloon-occluded retrograde transvenous obliteration plug-assisted retrograde transvenous obliteration gastrorenal shunt hepatic encephalopathy sodium tetradecyl sulfate |
| title | Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study |
| title_full | Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study |
| title_fullStr | Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study |
| title_full_unstemmed | Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study |
| title_short | Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study |
| title_sort | retrograde transvenous obliteration of gastric varices using sodium tetradecyl sulphate technical considerations and results from a single institution retrospective study |
| topic | bleeding gastric varices retrograde transvenous obliteration balloon-occluded retrograde transvenous obliteration plug-assisted retrograde transvenous obliteration gastrorenal shunt hepatic encephalopathy sodium tetradecyl sulfate |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1728998 |
| work_keys_str_mv | AT pushpinderskhera retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT pawankgarg retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT sarbeshtiwari retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT narendrabhargava retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT tarunayadav retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT binitsureka retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT tusharghosh retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT santhoshbabu retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT sunildadhich retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy AT surjitsingh retrogradetransvenousobliterationofgastricvaricesusingsodiumtetradecylsulphatetechnicalconsiderationsandresultsfromasingleinstitutionretrospectivestudy |