Efficacy of balloon-occluded retrograde transvenous obliteration, percutaneous transhepatic obliteration and combined techniques for the management of gastric fundal varices

Table 1 Main clinical and biochemical characteristics of 93 patients treated with interventional radiology for gastric varices n (%)

Clinical characteristics	BRTO	PTO	Com-T	Total
Sex (M/F)	37/38	5/3	5/5	47/46
Age (mean ± SD)	63.4 ± 10.0	62.9 ± 8.4	68.9 ± 12.8	63.9 ± 10.2
Cause of portal hypertension
Alcoholic liver cirrhosis	10 (13)	1 (13)	3 (30)	14 (15)
HBV (+) liver cirrhosis	3 (4)	0 (0)	1 (10)	4 (4)
HCV (+) liver cirrhosis	52 (69)	6 (75)	5 (50)	63 (68)
HBV (-) HCV (-) liver cirrhosis	7 (9)	0 (0)	1 (10)	8 (9)
Idiopathic portal hypertension	1 (1)	1 (13)	0 (0)	2 (2)
Primary biliary cirrhosis	1 (1)	0 (0)	0 (0)	1 (1)
Traumatic	1 (1)	0 (0)	0 (0)	1 (1)
Presence of Hepatocellular carcinoma	21 (28)	0 (0)	0 (0)	21 (23)
Child-Pugh class
A	42 (56)	3 (38)	7 (70)	52 (56)
B	29 (39)	4 (50)	2 (20)	35 (38)
C	2 (3)	0 (0)	1 (10)	3 (3)
Location of gastric varices
IGV1	56 (75)	2 (25)	9 (90)	67 (72)
GOV2	19 (25)	6 (75)	1 (10)	26 (28)
Form of gastric varices
Tumorous	26 (35)	1 (13)	2 (20)	29 (31)
Nodular	49 (65)	7 (88)	8 (80)	64 (69)
Previous gastric variceal bleeding
Present	36 (48)	4 (50)	2 (20)	42 (45)
Absent	39 (52)	4 (50)	8 (80)	51 (55)
Temporary hemostasis
Clipping	3 (4)	1 (13)	2 (20)	6 (7)
EVL	5 (7)	1 (13)	0 (0)	6 (7)
Histacryl	3 (4)	1 (13)	0 (0)	4 (4)
Balloon tamponade	2 (3)	0 (0)	0 (0)	2 (2)
Spontaneous	23 (31)	1 (13)	0 (0)	24 (26)
Duration of hospitalization (mean ± SD, d)	17.9 ± 23.4	14.6 ± 12.8	10.4 ± 4.0	16.8 ± 21.4
Follow-up (mean ± SD, d)	1040 ± 713	600 ± 381	704 ± 389	966 ± 677
Range (d)	35 - 2805	1134 - 150	83 - 1183	35 - 2805

BRTO : Balloon occluded retrograde transvenous obliteration; PTO : Percutaneous transhepatic obliteration; Com-T : Combined therapy; EVL : Endoscopic variceal ligation; IGV1: Isolated gastric varices; GOV2 : Gastroesophageal varices.

Table 2 Results of 93 patients treated with radiologic embolotherapy for gastric varices n (%)

Results	BRTO		PTO		Com-T		Total
Complete disappearance of gastric varices	75		8		10		93
Variceal rebleeding	1	(1)	1	(13)	0		2	(2)
Recurrence of gastric varices	3	(4)	3	(38)	0		6	(7)
Aggravation of esophageal varices	27	(36)	3	(38)	3	(30)	33	(36)
Death	21	(28)	0		2	(30)	23	(25)
Cause of death
Hepatic failure	8	(11)	0		1	(10)	9	(10)
Hepatocellular carcinoma	8	(11)	0		0		8	(9)
Cerebral hemorrhage	2	(3)	0		0		2	(2)
Renal failure	2	(3)	0		0		2	(2)
Pneumonia	1	(1)	0		0		1	(1)
Psychosis	0		0		1	(10)	1	(1)

Table 3 Complication of treatment n (%)

Complication	BRTO		PTO		Com-T		Total
Fever	47	(63)	4	(50)	9	(90)	60	(65)
Hemoglobinuria	35	(47)	3	(38)	10	(100)	48	(52)
Abdominal pain	48	(64)	6	(75)	7	(70)	66	(71)
Nausea	31	(41)	4	(50)	6	(60)	41	(44)
Blood pressure elevation1	22	(29)	2	(25)	4	(40)	28	(30)
Ascites	3	(4)	0		0		3	(3)
Pleural effusion	5	(7)	0		0		5	(5)
Headache	6	(8)	0		0		6	(7)
Hepatic encephalopathy	1	(1)	0		0		1	(1)
Chest pain	24	(32)	2	(25)	7	(70)	33	(36)

¹More than 20 mmHg elevation.