Yoshimatsu Rika, Yamagami Takuji, Ishikawa Masaki, Kajiwara Kenji, Fukumoto Wataru, Aikata Hiroshi, Chayama Kazuaki, Baba Yasutaka, Awai Kazuo
a Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences , Hiroshima University , Hiroshima , Japan.
b Department of Radiology , Kochi University Medical School , Kochi , Japan.
Minim Invasive Ther Allied Technol. 2017 Feb;26(1):1-6. doi: 10.1080/13645706.2016.1218346. Epub 2017 Jan 13.
The purpose of this study was to evaluate changes in thrombosis in gastric varices.
Fourteen patients were studied who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) for gastric varices with a gastrorenal shunt. The B-RTO catheter was retained overnight in all patients. Balloon-occluded retrograde venography (B-RTV) was performed to evaluate the degree of thrombus formation. This evaluation was done twice during the overnight B-RTO procedure: A few hours after the procedure and on the following day. Investigated were the degree of thrombus formation observed by the first and second B-RTV, change in the degree of thrombus between the first and second B-RTV, and whether and how much sclerosing agent was administered on the second day.
The first B-RTV showed entire or partial enhancement of the gastric varix in seven (50%) cases and complete or almost complete lack of enhancement in the remaining seven cases. In four of the former seven cases, the second B-RTV showed entire or partial enhancement of the gastric varix, and the sclerosing agent was added. However, in the remaining ten cases, enhancement was almost or completely lacking.
When complete thrombosis is shown on B-RTV obtained a few hours after B-RTO, the addition of a sclerotic agent would be unnecessary.
本研究旨在评估胃静脉曲张血栓形成的变化。
对14例行球囊闭塞逆行静脉栓塞术（B-RTO）治疗胃静脉曲张并伴有脾肾分流的患者进行研究。所有患者的B-RTO导管均保留过夜。行球囊闭塞逆行静脉造影（B-RTV）以评估血栓形成程度。在B-RTO过夜过程中进行两次评估：术后数小时及次日。观察指标包括首次和第二次B-RTV观察到的血栓形成程度、两次B-RTV之间血栓程度的变化以及第二天是否使用硬化剂及使用剂量。
首次B-RTV显示7例（50%）胃静脉曲张有全部或部分强化，其余7例完全或几乎完全无强化。在前7例中的4例中，第二次B-RTV显示胃静脉曲张有全部或部分强化，并追加了硬化剂。然而，在其余10例中，几乎或完全无强化。
B-RTO术后数小时获得的B-RTV显示完全血栓形成时，无需追加硬化剂。
