Tanoue Shuichi, Kiyosue Hiro, Matsumoto Shunro, Hori Yuzo, Okahara Mika, Kashiwagi Junji, Mori Hiromu
Department of Academic Radiology, Oita University Faculty of Medicine, Idaigaoka, 1-1, Hasama-machi, Oita-gun, Oita, 879-593, Japan.
Cardiovasc Intervent Radiol. 2006 Nov-Dec;29(6):991-6. doi: 10.1007/s00270-005-0039-7.
To develop a new coaxial balloon catheter system and evaluate its clinical feasibility for balloon-occluded retrograde transvenous obliteration (B-RTO).
A coaxial balloon catheter system was constructed with 9 Fr guiding balloon catheter and 5 Fr balloon catheter. A 5 Fr catheter has a high flexibility and can be coaxially inserted into the guiding catheter in advance. The catheter balloons are made of natural rubber and can be inflated to 2 cm (guiding) and 1 cm (5 Fr) maximum diameter. Between July 2003 and April 2005, 8 consecutive patients (6 men, 2 women; age range 33-72 years, mean age 55.5 years) underwent B-RTO using the balloon catheter system. Five percent ethanolamine oleate iopamidol (EOI) was used as sclerosing agent. The procedures, including maneuverability of the catheter, amount of injected sclerosing agent, necessity for coil embolization of collateral draining veins, and initial clinical results, were evaluated retrospectively. The occlusion rate was assessed by postcontrast CT within 2 weeks after B-RTO.
The balloon catheter could be advanced into the proximal potion of the gastrorenal shunt beyond the collateral draining vein in all cases. The amount of injected EOI ranged from 3 to 34 ml. Coil embolization of the collateral draining vein was required in 2 cases. Complete obliteration of gastric varices on initial follow-up CT was obtained in 7 cases. The remaining case required re-treatment that resulted in complete obstruction of the varices after the second B-RTO. No procedure-related complications were observed.
B-RTO using the new coaxial balloon catheter is feasible. Gastric varices can be treated more simply by using this catheter system.
研发一种新型同轴球囊导管系统，并评估其在球囊闭塞逆行静脉栓塞术（B-RTO）中的临床可行性。
用9F引导球囊导管和5F球囊导管构建同轴球囊导管系统。5F导管柔韧性高，可预先同轴插入引导导管。导管球囊由天然橡胶制成，最大可膨胀至2厘米（引导导管）和1厘米（5F导管）直径。2003年7月至2005年4月，连续8例患者（6例男性，2例女性；年龄范围33-72岁，平均年龄55.5岁）使用该球囊导管系统接受B-RTO治疗。5%油酸乙醇胺碘帕醇（EOI）用作硬化剂。回顾性评估操作过程，包括导管的可操作性、硬化剂注射量、侧支引流静脉进行弹簧圈栓塞的必要性以及初步临床结果。B-RTO术后2周内通过增强CT评估闭塞率。
在所有病例中，球囊导管均可推进至胃肾分流近端，超过侧支引流静脉。EOI注射量为3至34毫升。2例患者需要对侧支引流静脉进行弹簧圈栓塞。7例患者在首次随访CT时胃静脉曲张完全闭塞。其余1例患者需要再次治疗，在第二次B-RTO后静脉曲张完全阻塞。未观察到与操作相关的并发症。
使用新型同轴球囊导管进行B-RTO是可行的。使用该导管系统可更简单地治疗胃静脉曲张。
