Department of Radiology, Seoul National University College of Medicine; Institute of Radiation Medicine, Seoul National University Medical Research Center; and Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
J Vasc Interv Radiol. 2010 Apr;21(4):503-7. doi: 10.1016/j.jvir.2009.11.023. Epub 2010 Feb 20.
To evaluate the prevalence, risk factors, and clinical outcome after balloon rupture during balloon-occluded retrograde transvenous obliteration (BRTO).
Sixty-nine patients who underwent the BRTO procedure from August 1999 to January 2009 were analyzed retrospectively. The occurrence of balloon rupture was recorded by a review of medical records and imaging studies. The chi(2) test was used to analyze risk factors for balloon rupture including balloon type and size, amount of sclerosant, and the use of microcatheters. The influence of balloon rupture on migration of the sclerosant and in-hospital mortality was analyzed with the Fisher exact test.
The prevalence of balloon rupture was 8.7% (six of 69 patients). No significant risk factor for balloon rupture was identified because of the small number of balloon rupture cases. Migration of the sclerosant occurred in three patients with early balloon rupture within 1 hour. One of these patients died of recurrent gastric variceal bleeding and another experienced dyspnea and died of fungal sepsis. Among the 63 patients without rupture, no migration of the sclerosant was noted, and one patient died of sepsis caused by liver abscess. Incidences of sclerosant migration and in-hospital mortality were significantly higher in patients with balloon rupture versus patients without balloon rupture (P = .018 and P < .001, respectively).
Balloon rupture during BRTO occurred in 8.7% of patients. Balloon rupture may cause rapid migration of sclerosant, pulmonary embolism, and recurrent gastric variceal bleeding.
评估球囊阻塞逆行经静脉闭塞术（BRTO）中球囊破裂的发生率、危险因素和临床转归。
回顾性分析 1999 年 8 月至 2009 年 1 月期间行 BRTO 术的 69 例患者。通过病历和影像学检查回顾记录球囊破裂的发生情况。采用卡方检验分析球囊破裂的危险因素，包括球囊类型和大小、硬化剂用量和微导管的使用。采用 Fisher 确切检验分析球囊破裂对硬化剂迁移和住院死亡率的影响。
球囊破裂的发生率为 8.7%（6 例/69 例患者）。由于球囊破裂的病例数较少，未发现球囊破裂的显著危险因素。3 例早期（1 小时内）球囊破裂的患者出现硬化剂迁移。其中 1 例因复发性胃静脉曲张出血死亡，另 1 例出现呼吸困难并死于真菌感染性败血症。在 63 例未破裂的患者中，未发现硬化剂迁移，1 例患者因肝脓肿引起的败血症死亡。与无球囊破裂的患者相比，有球囊破裂的患者中硬化剂迁移和住院死亡率显著更高（P =.018 和 P <.001）。
BRTO 中球囊破裂的发生率为 8.7%。球囊破裂可能导致硬化剂快速迁移、肺栓塞和复发性胃静脉曲张出血。
