Chibana Shin, Sakakibara Hiroyuki, Oguro Sota, Usuzaki Takuma, Kamada Hiroki, Tannai Hiromitsu, Takase Kei
Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan.
Radiol Case Rep. 2025 May 12;20(8):3666-3674. doi: 10.1016/j.radcr.2025.04.073. eCollection 2025 Aug.
We present occlusion using gelatin sponge in modified coil-assisted retrograde transvenous obliteration (Og-CARTO), a novel technique based on CARTO that incorporates gelatin sponge for variceal obliteration. This technique uses 2 microcatheters: 1 for sparse coil embolization in the efferent vein and the other to inject large gelatin sponge particles (5-mm squares) into the varices, facilitating controlled blood flow stagnation prior to sclerosant administration. By eliminating prolonged balloon occlusion, Og-CARTO simplifies the procedure and reduces procedural burden. We successfully applied this technique in three cases with varying variceal anatomies, achieving complete thrombosis without significant complications. Og-CARTO provides a practical, cost-effective alternative when balloon occlusion is challenging and shows potential for broader clinical application.
我们介绍了在改良线圈辅助逆行静脉闭塞术（Og-CARTO）中使用明胶海绵进行闭塞的方法，这是一种基于CARTO的新技术，该技术采用明胶海绵进行静脉曲张闭塞。该技术使用2根微导管：1根用于在流出静脉中进行稀疏线圈栓塞，另一根用于将大的明胶海绵颗粒（5毫米见方）注入静脉曲张，便于在注射硬化剂之前控制血流停滞。通过消除长时间的球囊闭塞，Og-CARTO简化了操作并减轻了操作负担。我们成功地将该技术应用于3例静脉曲张解剖结构各异的病例，实现了完全血栓形成且无明显并发症。当球囊闭塞具有挑战性时，Og-CARTO提供了一种实用、经济高效的替代方法，并显示出更广泛临床应用的潜力。
